Controversies in the Current Management of Lumbar Hernias

Abstract

Background: Abdominal wall surgery has changed dramatically in recent years. The current management of lumbar hernias should reflect the development of modern imaging techniques and new forms of noninvasive treatment. Objective: To review and update knowledge on lumbar hernias. Data Sources: Literature review using MEDLINE with the key words "lumbar hernia" for the years 1950 through 2004. For an analysis prior to this date (1750-1950), we used cases reported by Thorek. Our own study of 28 patients was also included. Study Selection: All articles reporting clinical cases on lumbar hernia. Data Extraction: Two reviewers analyzed the epidemiological, clinical, and treatment data of the articles. Data Synthesis: One hundred thirty-five clinical case articles and 8 studies with more than 5 patients, together with our personal experience of 28 cases, were ana

Bilateral Lumbar Hernias - A Case Report and An Overview of the Current Literature

“…Some have also found MRI useful in confirming lumbar hernia defects [15,17,18]. In contrary to the aforementioned, albeit our patient belongs to the acquired primary type of lumbar hernia, she did not have the typical risk factors for lumbar hernias, hence the development of her lumbar hernias was likely a result of anatomical alterations of the posterior abdominal wall caused by aging [6].…”

“…Lumbar hernia is a rare condition. It was estimated that only around 300 cases have been reported in the literature [5,6]. However, the incidence of bilateral lumbar hernias was mostly described in the pediatric population, in which case they were classified as congenital and usually associated with other inborn abnormalities [7][8][9][10][11].…”

Bilateral superior lumbar hernias: a case report and review of literature

“…8 The loss of fatty tissue enables the rupture of neurovascular orifices that penetrate lumbodorsal fascia, and elevated intra-abdominal pressure acts as an initiating element. 9 The clinical presentation of Lumbar hernia is mysterious and non-specific. This consists of flank pain, back ache, nausea, feeling of weight or dragging sensation in the lumbar region.…”

Grynfeltt Hernia with Spiegel Hernia: Report of a Rarely Encountered Case Running Head: Grynfeltt Hernia

“…The rare Grynfeltt hernia occurs at superior lumbar triangle. The most common symptom is posterolateral bulging increases in size with strenuous activity, and can present as vague back pain, bowel, or urinary obstruction (3,4). Hernia repairs require the use of mesh.…”

“…Most of these hernias are acquired (80%), and acquired hernias are subdivided into two: spontaneous (primary) and seconder hernias. Advanced age, obesity, extreme thinness, intense slimming, presence of chronic debilitating disease, muscular atrophy, chronic bronchitis, wound infection and postoperative sepsis are the risk factors associated with occurrence of primary hernia (4).Direct contusion, crushing, surgical lesions or infections of pelvic bones and ribs, hepatic abscesses, infected retroperitoneal hematomas, and infectious processes altering the integrity of the lumbosacral fascia are responsible in mechanisms of pathogenesis of secondary acquired hernias (3,4).Preoperative imaging procedures are usually performed to identify the fascial defects, and eliminate the other pathologies. The CT findings are helpful especially in patients with atypical clinics.…”