Etiologic diagnosis of recurrent or persistent post-operative sciatica is currently based on magnetic resonance imaging (MRI), which helps distinguish central and lateral spinal stenosis from disc herniation, persistent herniated fragment or peridural fibrosis [ 11].
Minimally invasive retropleural approaches using tubular retractor systems for central or calcified thoracic disc herniation have been described via a lateral mini-open approach [ 71].
In conclusion, PLLD was a promising strategy with great potential for patients with central or paracentral L3 L5 disc herniation due to its good safety and minimal invasion.
Other conditions, such as central or lateral spinal stenosis, disc herniation, isthmic spondylolisthesis, postoperative instability, and degenerative scoliosis are mutually exclusive diagnoses in the register and they were therefore excluded from the present analysis.
Contrast administration is key in distinguishing recurrent disc herniation from peridural fibrosis, with disc herniations demonstrating early central nonenhancement and peripheral enhancement due to granulation tissue or dilated epidural venous plexus, whereas fibrosis demonstrates diffuse enhancement.
These same properties, however, may be beneficial after disc herniation, stimulating degradation of herniated tissue and encouraging spontaneous disc resorption.
Exclusion criteria were: acute and sub-acute LBP, specific causes of LBP (disc herniation, lumbar stenosis, spinal deformity, fracture, spondylolistesis), central or peripheral neurologic signs, systemic illness (tumour and rheumatologic diseases), psychiatric and mental deficits.
"You can't use an M.R.I. to say, 'This person must have really bad back pain and therefore must be disabled.' It is extremely common to have disc bulge and disc degeneration and disc herniation and have no symptoms whatsoever".
Disc herniation may occur in any direction.
Background context: Thoracic disc herniation is a rare condition.
