European Spine Journal

, Volume 15, Issue 5, pp 570–574 | Cite as

Lumbar disk herniation with contralateral symptoms

Original Article


The aim of the study is to determine if leg pain can be caused by contralateral lumbar disk herniation and if intervention from only the herniation side would suffice in these patients. Five patients who had lumbar disk herniations with predominantly contralateral symptoms were operated from the side of disk herniation without exploring or decompressing the symptomatic side. Patients were evaluated pre- and postoperatively. To our knowledge, this is the first reported series of such patients who were operated only from the herniation side. The possible mechanisms of how contralateral symptoms predominate in these patients are also discussed. In all patients, the shape of disk herniations on imaging studies were quite similar: a broad-based posterior central–paracentral herniated disk with the apex deviated away from the side of the symptoms. The symptoms and signs resolved in the immediate postoperative period. Our data clears that sciatica can be caused by contralateral lumbar disk herniation. When operation is considered, intervention only from the herniation side is sufficient. It is probable that traction rather than direct compression is responsible from the emergence of contralateral symptoms.


Contralateral symptoms Disk herniation Lumbar CT MRI 


  1. 1.
    Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW (1990) Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 72:403–408PubMedGoogle Scholar
  2. 2.
    Choudhury AR, Taylor JC, Worthington BS, Whitaker R (1978) Lumbar radiculopathy contralateral to upper lumbar disc herniation: report of 3 cases. Br J Surg 65:842–844PubMedGoogle Scholar
  3. 3.
    Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS (1994) Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 331:69–73CrossRefPubMedGoogle Scholar
  4. 4.
    Kornberg M (1994) Sciatica contralateral to lumbar disk herniation. Orthopedics 17:362–364PubMedGoogle Scholar
  5. 5.
    Mirovsky Y, Halperin N (2000) Eccentric compression of the spinal canal causing dominantly contralateral-side symptoms. Spinal Disord 13:174–177CrossRefGoogle Scholar
  6. 6.
    Spencer DL, Irwin GS, Miller JA (1983) Anatomy and significance of fixation of the lumbosacral nerve roots in sciatica. Spine 8:672–679PubMedGoogle Scholar
  7. 7.
    Walsh TR, Weinstein JN, Spratt KF, Lehmann TR, Aprill C, Sayre H (1990) Lumbar discography in normal subjects. A controlled, prospective study. J Bone Joint Surg Am 72:1081–1088PubMedGoogle Scholar
  8. 8.
    Wiesel SW, Tsourmas N, Feffer HL, Citrin CM, Patronas N (1984) A study of computer-assisted tomography. I. The incidence of positive CAT scans in an asymptomatic group of patients. Spine 9:549–551PubMedGoogle Scholar
  9. 9.
    Wilberger JE Jr, Pang D (1983) Syndrome of the incidental herniated lumbar disc. J Neurosurg 59:137–141PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Department of NeurosurgeryIzmir Ataturk Research and Training HospitalIzmirTurkey
  2. 2.Department of RadiologyIzmir Ataturk Research and Training HospitalIzmirTurkey

Personalised recommendations