Shanghai Donglei Brain Hospital: 1-cm Minimally Invasive Surgery for Extreme Lateral Lumbar Disc Herniation

Extreme lateral lumbar disc herniation (ELLDH) is a special subtype of lumbar disc herniation. It often causes radiating leg pain along the buttock, outer thigh, anterolateral lower leg and dorsum of the foot, while back pain is usually mild.

ELLDH is like a hidden assassin in the spinal maze. The herniation occurs outside the intervertebral foramen, compressing the exiting nerve root and causing severe radiating pain; severe cases lead to difficulty walking.

It accounts for 3% to 10% of all lumbar disc herniations. It is easily missed on routine axial CT/MRI and usually requires thin-slice CT/MRI for accurate diagnosis.

Surgery is the first choice for patients with severe symptoms and persistent pain that fails conservative treatment (medication, physical therapy and the like). The goal is to remove the herniated disc tissue and decompress the nerve root.

Percutaneous endoscopic lumbar discectomy is a safe and effective minimally invasive option, offering smaller trauma, faster recovery, shorter hospital stay, lower cost and fewer complications than open surgery.

In the first quarter of 2025, Shanghai Donglei Brain Hospital successfully performed this procedure on two patients with ELLDH, with excellent outcomes.

Led by Chief Specialist Wen Chaolun, the team completed precise preoperative planning. The procedure used only a 1-cm tiny incision to achieve full nerve root decompression.

All patients achieved significant pain relief immediately after surgery, walked on postoperative day 2, and enjoyed greatly improved quality of life. The department works with rehabilitation specialists to provide personalized postoperative plans that strengthen the lumbar muscles and reduce recurrence.

Warning Signs — Seek Medical Help Immediately

• Night pain awakening you more than twice per week
• Worsening radiating leg pain when coughing
• Persistent numbness on the outer dorsum of the foot