Complaints in hernia patients are usually seen on the side of the hernia. However, there are some patients who have a herniated disc on one side, but their complaints are on the opposite side. For example, as a result of the examinations, it is clearly determined that the disc has herniated towards the right side, but the patient’s signs and symptoms such as pain, numbness, loss of sensation are in the left leg. Of course, the opposite can also happen.
Such a clinical picture also occurs as a result of compression of nerve elements. The disc protrudes into the canal from the right or left side, pushing the nerves and compressing them on the opposite side. If the facet joint on the opposite side of the herniated disc is larger than normal or if there are irregularities on the surface of the bony structure on the opposite side, the nerves are more easily compressed on that side (Figs C and D). Thus, the patient’s complaints appear on the opposite side. However, the doctor plans the treatment according to the herniated disc, and if there is an operation, it is performed from the herniated side. As a result, when the herniated disc is evacuated, the patient’s complaints on the opposite side also cease.
We rarely come across a hernia on the opposite side during our daily practice. Since the scientific explanation of the subject is possible, the picture we encounter does not surprise us, the doctors, and as a result of the explanations we make, the patient learns why his pain and other complaints are on the opposite side according to the magnetic resonance and / or computed tomography report and gets rid of his anxiety.
In Figure A, the herniated disc and the patient’s complaints are on the same side. In Figure B, the herniated disc is on the left, and the patient’s complaints are on the right. In Figure C, the facet joint on the opposite side of the herniated disc is larger than normal (hypertrophic). Figure D shows irregularity in the bone structure on the opposite side. Thus, the nerve elements are more easily compressed on the opposite side (Figs C and D).
