• Pain physician · Mar 2015

    Case Reports

    Lumbar disc herniation with contralateral radiculopathy: do we neglect the epidural fat?

    • Jun-Song Yang, Dong-Jie Zhang, and Ding-Jun Hao.
    • Department of Spinal Surgery, Hong-Hui Hospital Medical College of Xi'an Jiaotong University, Xi'an, 710054, China.
    • Pain Physician. 2015 Mar 1;18(2):E253-6.

    AbstractLumbar disc herniation (LDH) is the most common cause of radiculopathy, whose pathological entity underlying nerve root compression is usually on the same side as the symptoms. However, LDH causing contralateral radiculopathy are sometimes encountered by pain physicians. There have been tremendous developments in the treatment options for LDH; the situation of LDH causing contralateral radiculopathy is indeed a dilemma for some pain physicians. We will report a case of a patient with a L4-5 disc herniation whose left herniated disc caused radiculopathy on the right side. After a percutaneous lumbar endoscopic discectomy via the side ipsilateral to the symptomatic side, this case obtained a significant symptom remission. The migrated epidural fat is discussed as a cause of associated contralateral neurological deficit. Only via a surgical approach ipsilateral to the herniated side, could there be a clinical improvement postoperatively.

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