• Anja Tschugg, Sara Lener, Sebastian Hartmann, Valentin Fink, Sabrina Neururer, Matthias Wildauer, Wolfgang N Löscher, and Claudius Thome.
• Department of Neurosurgery, Innsbruck Medical University, Anichstrasse 35, A-6020, Innsbruck, Austria.
• Muscle Nerve. 2018 Nov 1; 58 (5): 676-680.

IntroductionExtraforaminal lumbar disk herniations are characterized by distinct clinical features in comparison to paramedian lumbar disk herniations.MethodsWe applied the quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain in 63 patients with a single lumbar disk herniation. They were categorized in 2 groups: (I) an intraspinal (group I; n = 47, 75%) and an extraforaminal (group E; n = 16, 25%).ResultsThe wind-up ratio for assessing endogenous pain-modulating pathways was higher in group E (2.9 ± 2) than in group I (1.4 ± 1; P = 0.021). After a subsequent series of pinprick stimuli, an increase in pain assessed by the numeric rating scale could be shown in group E (2.1 ± 2 vs 1.1 ± 1; P = 0.032).DiscussionExtraforaminal compression is associated with chronic as well as neuropathic pain, presumably caused by direct compression of the dorsal root ganglion, which may preferentially promote specific chronic pain mechanisms. Muscle Nerve 58: 676-680, 2018.© 2018 Wiley Periodicals, Inc.

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