Lumbar and Other Unusual Hernias

The practicing general surgeon has an opportunity to these types of hernias very infrequently. While most surgeons will have an opportunity to repair a Spigelian hernia occasionally, many will never see or treat the unusual ones such as the lumbar or sciatic hernias. The lumbar hernia has recently become more frequent due to the increasing use of the lumbar approach to anterior fusion of the lumbar spine. However, in many instances these “hernias” actually represent pseudohernias because these lateral bulges are the result of intercostal nerve injury (T11 and T12) and subsequent paralysis of the flat muscles of the abdominal wall. These are especially difficult to treat.