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Lumbar disc herniation with contralateral radiculopathy: a systematic review on pathophysiology and surgical strategies.
Ruschel, Leonardo Gilmone; Agnoletto, Guilherme José; Aragão, Afonso; Duarte, Joel Sanabria; de Oliveira, Matheus Fernandes; Teles, Alisson R.
Afiliação
  • Ruschel LG; DFV Neuro, São Paulo, Brazil.
  • Agnoletto GJ; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
  • Aragão A; Neurosurgery Department, Neurological Institute of Curitiba (INC), Curitiba, Paraná, Brazil.
  • Duarte JS; Neurosurgery Department, University of Utah, Salt Lake City, UT, USA.
  • de Oliveira MF; Neurosurgery Department, Neurological Institute of Curitiba (INC), Curitiba, Paraná, Brazil.
  • Teles AR; Neurosurgery Department, Neurological Institute of Curitiba (INC), Curitiba, Paraná, Brazil.
Neurosurg Rev ; 44(2): 1071-1081, 2021 Apr.
Article em En | MEDLINE | ID: mdl-32281018
Lumbar disc herniation (LDH) is a relatively common pathology usually presenting with unilateral radiculopathy ipsilateral to the disc herniation. Some patients can present with contralateral radicular symptoms. The objective of this article is to review the current literature on lumbar disc herniations with contralateral radiculopathy regarding its pathophysiology and surgical strategies. A systematic review of the literature on LDH with contralateral radiculopathy was performed using MEDLINE (via PubMed) using MeSH terms. This review was done following recommendations of PRISMA statement and PICOT strategy of search. Initial electronic search identified 126 papers. Finally, 18 articles were reviewed. None of the included papers was described as comparative. Pathophysiological processes underlying contralateral pain may include prominent spondylotic changes and the accompanying stenosis; hypertrophic yellow ligament; dural attachments along the posterior longitudinal ligament; nerve root traction forces; and friction radiculitis, migrated epidural fat, nerve root anomaly, and venous congestion inside the vertebral canal. In our pooled analysis, 11 patients reported were treated by bilateral approach with 100% of clinical success and no complications. Eight patients were treated by unilateral approach ipsilateral to pain with 100% of clinical success and no complications. Forty-eight patients were treated by unilateral approach ipsilateral to herniation with 100% of clinical success and no complications. Pathophysiology underlying contralateral pain in LDH is probably multifactorial. There is not enough scientific evidence to define the best surgical approach for patients with LDH and contralateral pain.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Radiculopatia / Procedimentos Neurocirúrgicos / Deslocamento do Disco Intervertebral / Vértebras Lombares Tipo de estudo: Guideline / Observational_studies / Systematic_reviews Limite: Female / Humans / Male Idioma: En Revista: Neurosurg Rev Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Radiculopatia / Procedimentos Neurocirúrgicos / Deslocamento do Disco Intervertebral / Vértebras Lombares Tipo de estudo: Guideline / Observational_studies / Systematic_reviews Limite: Female / Humans / Male Idioma: En Revista: Neurosurg Rev Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha