A comparative Analysis of Spondylolysis Repair

Study Design This study analyzed a series of 83 patients operated on for foraminal lumbar disc herniation. Objectives This study sought to develop clinical and radiologic diagnoses, evaluate interlaminar and extra-articular exposures, and evaluate postoperative results. Summary of Background Data Some authors have reported a specific clinical syndrome, but other reports have indicated the clinical picture is indistinguishable from usual posterolateral disc herniation. Surgical man-agement often has been compared between the interlaminar and extra-artioular approaches. Methods Clinical findings were reviewed. All patients were evaluated with computed tomography, but radiologic diagnosis required computed tomographic discography for 26 patients. Interlaminar exposure with partial medical facetectomy was performed In 73 patients and an extra-articular approach was necessary in 10 patients, Postoperative results were evaluated with a 2-year follow-up. Results Foraminal lumbar disc herniations have a specific clinical picture, particularly severe radlcular signs. Precise preoperative radlologic evaluation is essential for successful operative procadure. Postoperative results were good in 76% of the patients. The other patients felt mild residual radicular pain, although no residual root compression was found on postoperative computed tomography. Only 21% of the patients that had a radicular deficit recovered totally. Conclusions Formainal lumbar disc hemiation involves characteristic clinical features, Radlologic diagnosis requires high-resoultion computed tomography, computed tomographic discography, or magnetic resonance imaging. Most foraminal lumbar disc herniations are reached through the Interlaminar exposure extended to the upper lamine and medial facet without total facetectomy, An extra-articular approach should be reserved for extra-foraminal herniations.