Ventrolateral lumbar disk herniation as an unusual presentation

Olivier Raskin, Ludovic Kaminski Published in the journal : May 2022 Category : Chirurgie orthopédique et traumatologie

Summary :

Acute lumbar pain is a common reason for patients attending primary care practices, with most of it being benign in nature.

One of its most frequent cause is a lumbar disk herniation, which can manifest itself only as a lower back pain, though it is usually associated with sciatica.

We have described herein a case of ventrolateral lumbar disk herniation crushing the psoas muscle origin, with a radiating pain that was not caused by nerve root compression. Nevertheless, like most cases of lumbar disk herniation, the pain improved with the passage of time and completely resolved within a few weeks, without any surgical procedure.

What is already known about the topic?

Lumbar disk herniation are one of the most current cause of acute lumbar pain. Their evaluation and treatment must be known by the primary care practicians.

The majority are benign, but it is important to well interrogate and examine the patients to exclude any severity sign.

Usually, the disk herniation and the pain trend to decrease naturally, so the first choice of treatment is medical.

The literature shows a propensity of the higher disks to herniate more laterally comparated to the lower one.

The ventrolateral herniation is not frequently reported in the literature.

What does this article bring up for us?

Symptomatic ventrolateral herniation of a lumbar disk are rarely described. This case add a new differential diagnose for acute lumbar and radicular pain.

It is also interesting to note the anatomo-clinical correlation between the position of the disk herniation and the pain which is provocated by the musculotendinous compression, not by the nerve root.

This kind of lumbar disk herniation seems to spontaneously decrease like the common ones so the medical treatment must be recommended.

Key Words

Lumbar disk herniation, cruralgia, radiculopathy, low back pain