Recoules-Arché D, Gayet A
Rev Rhum Mal Osteoartic. 1986 Mar;53(3):161-5.
Discal L4 crural neuralgia is conventionally considered secondary to a hernia of the L3-L4 disc. Now, another source of discoradicular conflict exists on the path of the L4 root: hernia of the link canal of the L4-L5 canal through which the root leaves the rachidian canal. Of 27 discal neuralgias operated upon, 9 were linked to a hernia of the L3-L4 disc, while 18 were secondary to a hernia of the L4-L5 foramen, that is 2 foramina hernias for 1 "intrarachidian" hernia. The diagnostic difficulties resulting from foramina hernias probably reflect a rarity that is more apparent than real. The etiology of crural neuralgia is conventionally sought at the L3-L4 disc. This search is often unsuccessful: one speaks of "essential crural neuralgia". The scanner provides the only certain way of revealing foramina hernias, and will probably detect increasing numbers and thus reduce the number of "idiopathic crural neuralgias".
传统上认为L4股神经痛继发于L3 - L4椎间盘疝。现在，在L4神经根走行路径上存在另一个椎间盘神经根冲突的来源：L4 - L5椎管连接管的疝，神经根通过该连接管离开椎管。在接受手术治疗的27例椎间盘神经痛中，9例与L3 - L4椎间盘疝有关，而18例继发于L4 - L5椎间孔疝，即每1例“椎管内”疝对应2例椎间孔疝。椎间孔疝导致的诊断困难可能反映出一种比实际情况更明显的罕见性。传统上在L3 - L4椎间盘寻找股神经痛的病因。这种寻找往往不成功：人们称之为“原发性股神经痛”。CT扫描是发现椎间孔疝的唯一确定方法，并且可能会检测到越来越多的病例，从而减少“特发性股神经痛”的数量。
