From 62 foraminal herniations seen over 2 years, the authors present a series of 22 lumbar foraminal disc herniations operated on by a combined interlaminar and extra-articular approach. After describing the technique the results are analysed. The objective of the combined approach is to provide satisfactory foraminal liberation without damage to the articular structures. They also define the indications. These are based on precise analysis of the topography of the hernia, provided by CAT scan examination. Three major topographical types may thus be defined.