• Dong Hwa Heo, Myeong Sub Lee, Seung Hun Sheen, Sung Min Cho, Yong Jun Cho, and Sae Moon Oh.
• Department of Neurosurgery, Chunchon Sacred Heart Hospital, College of Medicine, Hallym University, Chunchon, Korea. youmans@empal.com
• Spine. 2009 Oct 15;34(22):2419-23.

Study DesignProspective study evaluating the oblique lumbar magnetic resonance imaging (MRI).ObjectiveTo present the technique of oblique lumbar MRI and assess the clinical efficacy of this technique for diagnosis of extraforaminal disc herniation.Summary Of Background DataHerniated lumbar discs are traditionally diagnosed using conventional lumbar axial and sagittal MRI. However, conventional lumbar MRI might not reveal nerve root compression in the extraforaminal area. Oblique lumbar MRI can provide clear visualization of the dorsal root ganglion and lumbar nerve root in the foraminal and extraforaminal areas.MethodsTen patients diagnosed with extraforaminal disc herniations underwent bilateral oblique lumbar MRIs before surgery (turbo spin-echo T2-weighted sequence). We compared the side with symptomatic extraforaminal disc herniation to the asymptomatic contralateral side.ResultsOblique lumbar MRI succeeded in depicting pedicles, dorsal root ganglions, and lumbar nerve roots of the foraminal and extraforaminal areas. In 9 of 10 patients (90.0%), nerve root compression by the herniated disc in the extraforaminal area was clearly demonstrated when compared with the asymptomatic contralateral side (P < 0.05). In 1 patient with scoliosis and spinal stenosis, oblique MRI could not clearly display foraminal or extraforaminal anatomy due to spinal deformity.ConclusionIn light of this data, we suggest that oblique lumbar MRI can precisely demonstrate nerve roots in foraminal and extraforaminal areas. This technique is a simple and useful diagnostic tool for extraforaminal lumbar disc herniations.

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