Abstract

Lumbar radiculopathy is a constellation of symptoms including neurogenic back and lower extremity pain emanating from the lumbar nerve roots. In addition to pain, patients may experience numbness, weakness, and loss of reflexes. The causes of lumbar radiculopathy include herniated disk, foraminal stenosis, tumor, osteophyte formation, and, rarely, infection. Many patients and their physicians refer to lumbar radiculopathy as sciatica.

Patients suffering from lumbar radiculopathy complain of pain, numbness, tingling, and paresthesias in the distribution of the affected nerve root or roots. Patients may also note weakness and lack of coordination in the affected extremity. Muscle spasms and back pain, as well as pain referred into the buttocks, are common. Decreased sensation, weakness, and reflex changes are demonstrated on physical examination. Patients with lumbar radiculopathy commonly experience a reflex shifting of the trunk to one side, called list . Lasègue’s straight leg raising sign is almost always positive in patients with lumbar radiculopathy. Occasionally, patients suffering from lumbar radiculopathy experience compression of the lumbar spinal nerve roots and cauda equina that results in lumbar myelopathy or cauda equina syndrome; if so, they experience varying degrees of lower extremity weakness and bowel and bladder symptoms. This condition represents a neurosurgical emergency and should be treated as such.