{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:38:01Z","timestamp":1791405481342,"version":"4.3.3"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"22","license":[{"start":{"date-parts":[[2023,5,29]],"date-time":"2023-05-29T00:00:00Z","timestamp":1685318400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,29]]},"abstract":"\n BACKGROUND<\/jats:title>\n Contralateral lower limb radiculopathy is a potential early complication of oblique lumbar interbody fusion (OLIF) in degenerative lumbar disorders. Among several pathologies related to contralateral radiculopathy following OLIF, extraforaminal disc herniation during the OLIF procedure is very rare.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n Case 1 is a 68-year-old male underwent L4\u20135 and L5\u20136 OLIF for recurrent lumbar canal stenosis\u2013expressed right leg pain and muscle weakness after surgery. Case 2 is a 76-year-old female on whom L4\u20135 OLIF was performed for L4 degenerative spondylolisthesis and who presented right leg pain and numbness postoperatively. In both patients, OLIF cages were inserted into the posterior part of the disc space or obliquely and the extraforaminal extruded disc compressed opposite exiting nerve roots (L5 root in case 1 and L4 root in case 2) as shown on magnetic resonance imaging (MRI). Surgical decompression with discectomy was required for pain relief and neurological improvement in both cases.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n When emerging from new-onset opposite limb radiculopathy attributed to the OLIF procedure, extraforaminal disc herniation should be considered a potential pathology and MRI is useful for early diagnosis and selecting a subsequent management, including surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case23198","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T08:53:56Z","timestamp":1685436836000},"source":"Crossref","is-referenced-by-count":3,"title":["Contralateral lower limb radiculopathy by extraforaminal disc herniation following oblique lumbar interbody fusion in degenerative lumbar disorder: illustrative cases"],"prefix":"10.3171","volume":"5","author":[{"given":"Satoshi","family":"Hattori","sequence":"first","affiliation":[{"name":"Hachioji Spine Clinic, Hachioji, Tokyo, Japan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Anan Medical Center, Anan, Tokushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"691","article-title":"A new microsurgical technique for minimally invasive anterior lumbar interbody fusion","volume":"22","author":"Mayer HM","year":"1997","unstructured":"Mayer HM. A new microsurgical technique for minimally invasive anterior lumbar interbody fusion. Spine (Phila Pa 1976). 1997;22(6):691\u2013700.9089943"},{"issue":"5","key":"b2","series-title":"J Neurosurg Spine","first-page":"785","article-title":"Retroperitoneal oblique corridor to the L2-S1 intervertebral discs in the lateral position: an anatomic study","volume":"21","author":"Davis TT","year":"2014","unstructured":"Davis TT, Hynes RA, Fung DA, Retroperitoneal oblique corridor to the L2-S1 intervertebral discs in the lateral position: an anatomic study. J Neurosurg Spine. 2014;21(5):785\u2013793."},{"key":"b3","series-title":"Surg Neurol Int","first-page":"S652","article-title":"High neurological complication rates for extreme lateral lumbar interbody fusion and related techniques: a review of safety concerns","volume":"7","author":"Epstein NE","year":"2016","unstructured":"Epstein NE. High neurological complication rates for extreme lateral lumbar interbody fusion and related techniques: a review of safety concerns. Surg Neurol Int. 2016;7(Suppl 25):S652\u2013S655.27843679"},{"issue":"1","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"E13","article-title":"Postoperative lumbar plexus injury after lumbar retroperitoneal transpsoas minimally invasive lateral interbody fusion","volume":"38","author":"Le TV","year":"2013","unstructured":"Le TV, Burkett CJ, Deukmedjian AR, Uribe JS. Postoperative lumbar plexus injury after lumbar retroperitoneal transpsoas minimally invasive lateral interbody fusion. Spine (Phila Pa 1976). 2013;38(1):E13\u2013E20.23073358"},{"key":"b5","series-title":"Eur Spine J","first-page":"378","article-title":"Can triggered electromyography monitoring throughout retraction predict postoperative symptomatic neuropraxia after XLIF? Results from a prospective multicenter trial","volume":"24","author":"Uribe JS","year":"2015","unstructured":"Uribe JS, Isaacs RE, Youssef JA, Can triggered electromyography monitoring throughout retraction predict postoperative symptomatic neuropraxia after XLIF? Results from a prospective multicenter trial. Eur Spine J. 2015;24(Suppl 3):378\u2013385.25874744"},{"issue":"3","key":"b6","series-title":"J Neurosurg Spine","first-page":"289","article-title":"Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization","volume":"18","author":"Ahmadian A","year":"2013","unstructured":"Ahmadian A, Deukmedjian AR, Abel N, Dakwar E, Uribe JS. Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization. J Neurosurg Spine. 2013;18(3):289\u2013297.23259543"},{"issue":"10","key":"b7","series-title":"Spine J","first-page":"1412","article-title":"Lateral lumbar interbody fusion: a systematic review of complication rates","volume":"17","author":"Hijji FY","year":"2017","unstructured":"Hijji FY, Narain AS, Bohl DD, Lateral lumbar interbody fusion: a systematic review of complication rates. Spine J. 2017;17(10):1412\u20131419.28456671"},{"issue":"2","key":"b8","series-title":"Orthop Surg","first-page":"98","article-title":"Complication and prevention strategies of oblique lateral interbody fusion technique","volume":"10","author":"Zeng ZY","year":"2018","unstructured":"Zeng ZY, Xu ZW, He DW, Complication and prevention strategies of oblique lateral interbody fusion technique. Orthop Surg. 2018;10(2):98\u2013106.29878716"},{"issue":"1","key":"b9","series-title":"Spine (Phila Pa 1976)","first-page":"55","article-title":"Perioperative complications in 155 patients who underwent oblique lateral lumbar interbody fusion surgery: perspective and indications from a retrospective multicenter survey","volume":"42","author":"Abe K","year":"2017","unstructured":"Abe K, Orita S, Mannoji C, Perioperative complications in 155 patients who underwent oblique lateral lumbar interbody fusion surgery: perspective and indications from a retrospective multicenter survey. 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J Minim Invasive Spine Surg Tech. 2021;6(2):109\u2013114."},{"key":"b15","series-title":"Spine (Phila Pa 1976)","first-page":"S322","article-title":"A prospective, nonrandomized, multicenter evaluation of extreme lateral interbody fusion for the treatment of adult degenerative scoliosis: perioperative outcomes and complications","volume":"35","author":"Isaacs RE","year":"2010","unstructured":"Isaacs RE, Hyde J, Goodrich JA, Rodgers WB, Phillips FM. A prospective, nonrandomized, multicenter evaluation of extreme lateral interbody fusion for the treatment of adult degenerative scoliosis: perioperative outcomes and complications. Spine (Phila Pa 1976). 2010;35(26 Suppl):S322\u2013S330.21160396"},{"issue":"1","key":"b16","series-title":"J Clin Neurosci","first-page":"149","article-title":"Contralateral femoral nerve compression: an unrecognized complication after extreme lateral interbody fusion (XLIF)","volume":"18","author":"Papanastassiou ID","year":"2011","unstructured":"Papanastassiou ID, Eleraky M, Vrionis FD. Contralateral femoral nerve compression: an unrecognized complication after extreme lateral interbody fusion (XLIF). J Clin Neurosci. 2011;18(1):149\u2013151.20965732"},{"issue":"3","key":"b17","series-title":"J Korean Orthop Assoc","first-page":"285","article-title":"Contralateral nerve root compression after direct lateral lumbar interbody fusion","volume":"52","author":"Son SM","year":"2017","unstructured":"Son SM, Kim TH, Shin JK, Lee JS. Contralateral nerve root compression after direct lateral lumbar interbody fusion. J Korean Orthop Assoc. 2017;52(3):285\u2013289."},{"issue":"1","key":"b18","series-title":"BMC Musculoskelet Disord","first-page":"217","article-title":"Efficacy and safety of a modified lateral lumbar interbody fusion in L4-5 lumbar degenerative diseases compared with traditional XLIF and OLIF: a retrospective cohort study of 156 cases","volume":"23","author":"Li J","year":"2022","unstructured":"Li J, Sun Y, Guo L, Zhang F, Ding W, Zhang W. Efficacy and safety of a modified lateral lumbar interbody fusion in L4-5 lumbar degenerative diseases compared with traditional XLIF and OLIF: a retrospective cohort study of 156 cases. BMC Musculoskelet Disord. 2022;23(1):217.35255886"},{"issue":"6","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"691","article-title":"A new microsurgical technique for minimally invasive anterior lumbar interbody fusion","volume":"22","author":"Mayer HM","year":"1997","unstructured":"Mayer HM. A new microsurgical technique for minimally invasive anterior lumbar interbody fusion. Spine (Phila Pa 1976). 1997;22(6):691\u2013700.9089943"},{"issue":"5","key":"b2","series-title":"J Neurosurg Spine","first-page":"785","article-title":"Retroperitoneal oblique corridor to the L2-S1 intervertebral discs in the lateral position: an anatomic study","volume":"21","author":"Davis TT","year":"2014","unstructured":"Davis TT, Hynes RA, Fung DA, Retroperitoneal oblique corridor to the L2-S1 intervertebral discs in the lateral position: an anatomic study. J Neurosurg Spine. 2014;21(5):785\u2013793."},{"key":"b3","series-title":"Surg Neurol Int","first-page":"S652","article-title":"High neurological complication rates for extreme lateral lumbar interbody fusion and related techniques: a review of safety concerns","volume":"7","author":"Epstein NE","year":"2016","unstructured":"Epstein NE. High neurological complication rates for extreme lateral lumbar interbody fusion and related techniques: a review of safety concerns. Surg Neurol Int. 2016;7(Suppl 25):S652\u2013S655.27843679"},{"issue":"1","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"E13","article-title":"Postoperative lumbar plexus injury after lumbar retroperitoneal transpsoas minimally invasive lateral interbody fusion","volume":"38","author":"Le TV","year":"2013","unstructured":"Le TV, Burkett CJ, Deukmedjian AR, Uribe JS. Postoperative lumbar plexus injury after lumbar retroperitoneal transpsoas minimally invasive lateral interbody fusion. Spine (Phila Pa 1976). 2013;38(1):E13\u2013E20.23073358"},{"key":"b5","series-title":"Eur Spine J","first-page":"378","article-title":"Can triggered electromyography monitoring throughout retraction predict postoperative symptomatic neuropraxia after XLIF? Results from a prospective multicenter trial","volume":"24","author":"Uribe JS","year":"2015","unstructured":"Uribe JS, Isaacs RE, Youssef JA, Can triggered electromyography monitoring throughout retraction predict postoperative symptomatic neuropraxia after XLIF? Results from a prospective multicenter trial. Eur Spine J. 2015;24(Suppl 3):378\u2013385.25874744"},{"issue":"3","key":"b6","series-title":"J Neurosurg Spine","first-page":"289","article-title":"Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization","volume":"18","author":"Ahmadian A","year":"2013","unstructured":"Ahmadian A, Deukmedjian AR, Abel N, Dakwar E, Uribe JS. Analysis of lumbar plexopathies and nerve injury after lateral retroperitoneal transpsoas approach: diagnostic standardization. J Neurosurg Spine. 2013;18(3):289\u2013297.23259543"},{"issue":"10","key":"b7","series-title":"Spine J","first-page":"1412","article-title":"Lateral lumbar interbody fusion: a systematic review of complication rates","volume":"17","author":"Hijji FY","year":"2017","unstructured":"Hijji FY, Narain AS, Bohl DD, Lateral lumbar interbody fusion: a systematic review of complication rates. Spine J. 2017;17(10):1412\u20131419.28456671"},{"issue":"2","key":"b8","series-title":"Orthop Surg","first-page":"98","article-title":"Complication and prevention strategies of oblique lateral interbody fusion technique","volume":"10","author":"Zeng ZY","year":"2018","unstructured":"Zeng ZY, Xu ZW, He DW, Complication and prevention strategies of oblique lateral interbody fusion technique. Orthop Surg. 2018;10(2):98\u2013106.29878716"},{"issue":"1","key":"b9","series-title":"Spine (Phila Pa 1976)","first-page":"55","article-title":"Perioperative complications in 155 patients who underwent oblique lateral lumbar interbody fusion surgery: perspective and indications from a retrospective multicenter survey","volume":"42","author":"Abe K","year":"2017","unstructured":"Abe K, Orita S, Mannoji C, Perioperative complications in 155 patients who underwent oblique lateral lumbar interbody fusion surgery: perspective and indications from a retrospective multicenter survey. Spine (Phila Pa 1976). 2017;42(1):55\u201362.27116114"},{"issue":"19","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"1478","article-title":"Complications associated with lateral interbody fusion: nationwide survey of 2998 cases during the first 2 years of its use in Japan","volume":"42","author":"Fujibayashi S","year":"2017","unstructured":"Fujibayashi S, Kawakami N, Asazuma T, Complications associated with lateral interbody fusion: nationwide survey of 2998 cases during the first 2 years of its use in Japan. Spine (Phila Pa 1976). 2017;42(19):1478\u20131484.28252557"},{"key":"b11","series-title":"Case Rep Orthop","first-page":"9142074","article-title":"Malposition of cage in minimally invasive oblique lumbar interbody fusion","volume":"2018","author":"Kraiwattanapong C","year":"2018","unstructured":"Kraiwattanapong C, Arnuntasupakul V, Kantawan R, Malposition of cage in minimally invasive oblique lumbar interbody fusion. Case Rep Orthop. 2018;2018:9142074.30123602"},{"issue":"22","key":"b12","series-title":"Spine (Phila Pa 1976)","first-page":"1959","article-title":"Contralateral motor deficits after lateral lumbar interbody fusion","volume":"38","author":"Taher F","year":"2013","unstructured":"Taher F, Hughes AP, Lebl DR, Contralateral motor deficits after lateral lumbar interbody fusion. Spine (Phila Pa 1976). 2013;38(22):1959\u20131963.23917644"},{"issue":"1","key":"b13","series-title":"J Neurosurg Case Lessons","first-page":"CASE21210","article-title":"Symptomatic contralateral osteophyte fracture with migration causing lumbar plexopathy during oblique lumbar interbody fusion: illustrative case [manuscript published online ahead of print July 5, 2021]","volume":"2","author":"Brenton P","year":"2021","unstructured":"Brenton P, Jeremy G, Dean C. 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J Korean Orthop Assoc. 2017;52(3):285\u2013289."},{"issue":"1","key":"b18","series-title":"BMC Musculoskelet Disord","first-page":"217","article-title":"Efficacy and safety of a modified lateral lumbar interbody fusion in L4-5 lumbar degenerative diseases compared with traditional XLIF and OLIF: a retrospective cohort study of 156 cases","volume":"23","author":"Li J","year":"2022","unstructured":"Li J, Sun Y, Guo L, Zhang F, Ding W, Zhang W. Efficacy and safety of a modified lateral lumbar interbody fusion in L4-5 lumbar degenerative diseases compared with traditional XLIF and OLIF: a retrospective cohort study of 156 cases. 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