11. Signs of lumbosacral radiculopathy Flashcards Preview

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Flashcards in 11. Signs of lumbosacral radiculopathy Deck (13)
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Sign of lumbosacral radiculopathy

paresthesias and weakness in distribution of specific lumbar or sacra spinal nerves

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lumbosacral radiculopathy is often due to

intervertebrral disc herniation in which the nerve association with the INFERIOR vertebral body is impinged

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L3-L4 disc herniatation - findings

Weakness of knee extension,
DECREASED patellar reflex

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L4–L5 disc herniatation - findings

Weakness of dorsiflexion,
difficulty in heelwalking

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L5–S1 disc herniatation - findings

Weakness of plantarflexion,
difficulty in toewalking,
DECREASED Achilles reflex

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example : l3-l4 inury disc herniation affects -->

L4 spinal nerve

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• What are hallmark signs and symptoms of a radiculopathy?

Paresthesias and weakness in distribution of specific lumbar or sacral spinal nerves

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• What is the most common cause of a radiculopathy?

Intervertebral disc herniation in which the nerve association with the inferior vertebral body is impinged

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• A patient suffers an L3–L4 disc herniation. Which nerve roots are impaired by this lesion?

The L4 nerve roots (in the lumbar spine, the nerve roots are found inferior to their associated vertebral body)

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• A man with back pain has weak left hip flexion and left patellar hyporeflexia. Herniation at which level, in which direction, is to blame?

Left posterolateral herniation of the L3–L4 intervertebral disc, impinging on the left L4 nerve root

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• Why are disc herniations more likely to occur posterolaterally as opposed to anteriorly?

Due to the thin posterior longitudinal ligament and thicker anterior longitudinal ligament along the midline of the vertebral bodies

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• A back-pain patient has dorsiflexion weakness. Lumbosacral MRI shows a disc herniation. On exam, what type of gait will be impaired in him?

Heel walking (dorsiflexion weakness suggests an impaired L5 nerve root from an L4–L5 disc herniation)

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• A back pain patient has difficulty with plantarflexion and toe walking. What reflex do you check to confirm your suspected diagnosis?

The Achilles reflex (impaired in S1 radiculopathies secondary to L5–S1 disc herniations

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