{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:01:32Z","timestamp":1790182892192,"version":"4.1.0"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1974,8]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The authors believe that posterior lumbar disc herniations that occur far laterally (beneath, or beyond the facet) present a clinical picture and special problems of diagnosis different from those encountered with the usual herniations within the spinal canal. In a series of 204 consecutive disc operations, there were 24 \u201cextreme-lateral\u201d disc herniations at the second, third, or fourth lumbar interspace, none at the lumbosacral joint. When compared with the incidence of posterior herniations above the fourth interspace, it appeared that \u201cextreme-lateral\u201d herniations were responsible for the majority of second, third and fourth lumbar root compressions. The clinical syndrome is characterized by anterior thigh and leg pain, absent knee jerk, and sensory loss in the appropriate dermatome but also by the absence of back pain, typical back signs, or positive Lasegue's sign. Reproduction of pain and paresthesia by lateral bending to the side of the lesion is a reliable diagnostic sign. The authors report that myelography fails to disclose these lesions, while discography often proves helpful.<\/jats:p>","DOI":"10.3171\/jns.1974.41.2.0229","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:00:46Z","timestamp":1241708446000},"page":"229-234","source":"Crossref","is-referenced-by-count":155,"title":["Extreme-lateral lumbar disc herniations"],"prefix":"10.3171","volume":"41","author":[{"given":"A. F.","family":"Abdullah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward W.","family":"Ditto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward B.","family":"Byrd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Bone Joint Surg (Amer)","doi-asserted-by":"publisher","first-page":"311","DOI":"10.2106\/00004623-196345020-00009","article-title":"Herniated upper lumbar discs.","volume":"45","author":"Aronson","year":"1963"},{"key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"410","DOI":"10.3171\/jns.1963.20.5.0410","article-title":"Disease of lumbar discs: ten years of surgical treatment.","volume":"20","author":"Brown","year":"1963"},{"key":"b3","series-title":"Lumbar Discography.","author":"Collis","year":"1963"},{"key":"b4","author":"Dohn","year":"1973"},{"key":"b5","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"376","DOI":"10.3171\/jns.1949.6.5.0376","article-title":"Failure to disclose ruptured intervertebral discs in 32 operations for sciatica.","volume":"6","author":"Echols","year":"1949"},{"key":"b6","author":"Gardner","year":"1973"},{"key":"b7","series-title":"Arch Surg (Chicago)","first-page":"355","article-title":"X-ray visualization of the intervetebral disc with a consideration of the morbidity of disc puncture.","volume":"64","author":"Gardner","year":"1952"},{"key":"b8","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"783","DOI":"10.3171\/jns.1961.18.6.0783","article-title":"Results of operative treatment of protruded and ruptured lumbar discs: based on 1176 operative cases with 82 per cent follow-up of 3 to 13 years.","volume":"18","author":"Gurdjian","year":"1961"},{"key":"b9","series-title":"The Weak Back: a Medical Study of the Endogenous Components of Disorders of the Back, Which Is Then Called a Degenerative Back.","author":"Hanraets","year":"1959"},{"key":"b10","series-title":"Operative Neurosurgery","first-page":"266","volume":"2","author":"Kempe","year":"1970"},{"key":"b11","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"413","DOI":"10.3171\/jns.1948.5.5.0413","article-title":"Spinal nerve injury in dorso-lateral protrusions of lumbar discs.","volume":"5","author":"Lindblom","year":"1948"},{"key":"b12","series-title":"J Bone Joint Surg (Brit)","first-page":"8","article-title":"Protrusions of the lumbar intervertebral discs: clinical review based on five hundred cases treated by excision of the protrusion (Hunterian Lecture).","volume":"33","author":"O'Connell","year":"1951"},{"key":"b13","series-title":"Surg Neurol","first-page":"267","article-title":"Lumbar discography: a five year study.","volume":"1","author":"Patrick","year":"1973"},{"key":"b14","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"604","DOI":"10.3171\/jns.1970.32.5.0604","article-title":"Removal of protruded lumbar intervertebral discs.","volume":"32","author":"Raaf","year":"1970"},{"key":"b15","series-title":"Amer J Surg","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1016\/0002-9610(59)90003-0","article-title":"Some observations regarding 905 patients operated upon for protruded lumbar intervertebral disc.","volume":"97","author":"Raaf","year":"1959"},{"key":"b16","series-title":"J Radiol Electr","first-page":"559","article-title":"Difficult\u00e9s du diagnostic des hernies discales lombaires et lombo-sacr\u00e9es.","volume":"51","author":"Salamon","year":"1970"},{"key":"b17","series-title":"Surg Gynec Obstet","first-page":"559","article-title":"Discrepancies in myelography. Statistical survey of 200 operative cases undergoing pantopaque myelography.","volume":"86","author":"Scoville","year":"1948"},{"key":"b18","article-title":"Ruptures of the Lumbar Intervertebral Disc.","author":"Semmes","year":"1964"},{"key":"b19","series-title":"Acta Orthop Scand","first-page":"459","article-title":"Lasegue's sign in patients with lumbar disc herniation.","volume":"42","author":"Sprangfort","year":"1971"},{"key":"b20","series-title":"Clin Neurosurg","first-page":"42","article-title":"Results in surgical treatment of herniated lumbar intervertebral discs: investigation of the late results in subjects with and without supplementary spinal fusion. A preliminary report.","volume":"13","author":"White","year":"1965"},{"key":"b21","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"520","DOI":"10.3171\/jns.1969.31.5.0520","article-title":"Discography: its role in the diagnosis of lumbar disc protrusion.","volume":"31","author":"Wilson","year":"1969"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/41\/2\/article-p229.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/41\/2\/article-p229.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/41\/2\/article-p229.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,10]],"date-time":"2022-07-10T23:24:57Z","timestamp":1657495497000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/41\/2\/article-p229.xml"}},"subtitle":["Clinical syndrome and special problems of diagnosis"],"short-title":[],"issued":{"date-parts":[[1974,8]]},"references-count":21,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/jns.1974.41.2.0229","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1974,8]]}}}