Please enable JavaScript.
Coggle requires JavaScript to display documents.
Lumbosacral Radiculopathy - Coggle Diagram
Lumbosacral Radiculopathy
Defined by
nerve root compression in the lumbosacral spine causing radiating leg pain.
Management
Conservative
NSAIDs / analgesics
Activity modification
Physiotherapy
Weight reduction
Interventional
Epidural steroid injections
Surgical
Discectomy / decompression
Indicated for:
Progressive neurological deficit
Cauda equina syndrome
Refractory pain
Etiology / Causes
Lumbar disc herniation
Degenerative disc disease
Lumbar spinal stenosis
Spondylolisthesis
Osteophytes
Trauma
Tumors / infections
Pathophysiology
Nerve root compression or inflammation
↓ Axonal conduction
Ischemia of nerve root
Release of inflammatory mediators
Affected Nerve Roots
L4
L5
S1
Clinical Features
Pain
Low back pain
Radiating leg pain (sciatica)
Dermatomal distribution
Sensory Symptoms
Numbness
Paresthesia (“pins and needles”)
Dermatomal sensory loss
Motor Symptoms
Muscle weakness
Gait difficulty
Foot drop (L5)
Dermatomal & Myotomal Patterns
L4 → Medial leg → Knee extension → ↓ knee jerk
L5 → Dorsum of foot → Dorsiflexion → Foot drop
S1 → Lateral foot → Plantarflexion → ↓ ankle jerk
Physical Examination
Positive Straight Leg Raise test
Dermatomal sensory loss
Myotomal weakness
Reflex asymmetry
Investigations
MRI lumbar spine (gold standard)
CT scan (if MRI contraindicated)
EMG / Nerve conduction studies (chronic or unclear cases)
Complications
Chronic pain
Persistent weakness
Disability
Cauda equina syndrome