Lumbar hernia manifest through two possible defects in the posterior abdominal wall- superior and inferior lumbar triangle
. The larger superior triangle is inverted, deeper and more constant.
The superior lumbar triangle is described by Grynfeltt and the inferior lumbar triangle
Physical examination shows reduced or absent segmental reflexes.2 To confirm the diagnosis a nerve conduction study must be done; electroneuromyography is used for this purpose.10 MRI with gaolinium-DTPA can help to define the extent of he inflammation and to exclude local entrapment of spinal nerve roots which is known to be a precipitating factor of herpes zoster.1112 Differential diagnosis includes lumbar hernias that can occur through the inferior lumbar triangle
of Petit or the superior triangle of Grynfeelt and other conditions such as diabetic truncal neuropathy syringomyelia polyradiculoneuropathy Lyme disease and prolapsed L1-L2 intervertebral disc.
For example, an Amyand's hernia is an inguinal hernia containing the appendix (Figure 2), a De Garengeot hernia is a femoral hernia containing the appendix, a hernia of Littre contains a Meckel's diverticulum, (5) a Grynflett-Lesshaft hernia occurs through the superior lumbar triangle, while a Petit hernia is a hernia in the inferior lumbar triangle
Lumbar hernias occur through two potential weak spaces, which are superior and inferior lumbar triangles
. The superior lumbar space of Grynfeltt and Lesshaft is the larger one.