الفهرس 
CONTENTS
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
In summary, The Extraforaminal (far lateral ) lumbar disc herniation should be kept in mind in the differential diagnosis of upper lumbar disc herniation in eldely patients , surgical treatment is the by far is the standard treatment for those type of herniationvia various surgical modalities.
Treating extraforaminal disc herniation with an extraforaminal (far lateral )ap-proach usingparamedian (intermuscular) technique is a safe, minimally traumatizing procedure,reducing the operativetime and amount of bleeding , yielding satisfactory results also offers a valid alternative to the midline approach . It requires minimal soft-tissue and bone resection and the herniated disc is directly visualized. Moreover, it determines minimal manipulation of theneurovascular structures and avoids significant muscle retraction and potential spinal instability due to excessive bone resection..
RECOMMENDATIONS:
Orthopedic spinesurgeons treating extraforaminal (far lateral ) lumbar disc herniation should be facile with the extraforaminal (far lateral )approach via a paramedian (intermuscular) technique . However, Some spinal surgeons are not familiar with this approach.
As the paramedian approach is far from the usual bony landmarks, it can lead to orientation problems in unexperienced hands. Under these circumstances, we recommend the use of the paramuscular (median) approach until the surgeon becomes familiar with the regional anatomy.
FURTHER RESEARCHS:
As surgical treatment is by far the standard treatment for the extraforaminal (far lateral ) lumbar disc herniation. But, as controversy persists among authors regarding optimal technique fortreatingthem , some parameters should be investigated to properly choose the convienttechniqueof treatment. These parameters can be summarized as follows:
I. Defining standard indications for every technique.
II. Correlation between the presence of other pathologies in conjunction with the extraforaminal (far lateral ) lumbar disc herniation.
III. The effect of the patient age on doing spinal fusion as adjuvant to far lateral discectomy .