The diagnosis of sequestered lumbar disc herniation.

The purpose of this paper was to describe the diagnosis of sequestered lumbar disc herniation. Sequestration of disc herniation is an important cause of failure of percutaneous nucleotomy and chemonucleolysis. It therefore is important to recognize this particular variety of disc herniation before considering this procedure. In order to determine the clinical and myelographic signs of sequestration, we reviewed the chart, myelograms and surgical findengs of 102 patients operated on for a disc herniation.We could not find a correlation between the clinical history, type and location of pain, and physical findings that suggested which patient had a sequestered disc herniation. We discovered that the radiological criteria for the diagnosis of a sequestered disc herniation were:1) A pendiculated disc herniation had a high likelihood of being sequestered.2) A disc herniation that was at the interpedicular level or subpedicular level also had a high likelihood of being sequestered.