Lumbosacral radiculopathy (sciatica)

Question 1

Define lumbosacral radiculopathy (sciatica)

Answer 1

Pain, tingling & numbness that arise from nerve root compression or irritation in the lumbosacral spine

Question 2

Aetiology of lumbosacral radiculopathy (sciatica)

1 +5

Answer 2

Most commonly caused by disc herniation

Other causes:
spinal stenosis
spondylolisthesis
spinal injury or infection
tumour 
cauda equina syndrome

Question 3

Epidemiology of lumbosacral radiculopathy (sciatica)

prevalence + gender

Answer 3

Relatively COMMON

More common in males

Question 4

Presenting symptoms & signs of lumbosacral radiculopathy (sciatica)
(4)

Answer 4

Pain (usually affects buttocks & legs more than the back)
Numbness
Tingling sensation that radiates from lower back down 1 of the legs
Weakness in calf muscles or muscles that move foot/ankle

Question 5

Investigations for lumbosacral radiculopathy (sciatica)

general + 2

Answer 5

CLINICAL diagnosis

Straight leg raise
CT/MRI

Question 6

Investigations for lumbosacral radiculopathy (sciatica) - straight leg raise
(3)

Answer 6

If pain in distribution of sciatic nerve
Positive sign (Lasegue’s sign) = pain reproduced on passive flexion of straight leg at hip between 30-70º
Sensitive test but not specific

Question 7

Investigations for lumbosacral radiculopathy (sciatica) - CT/MRI

Answer 7

Helps visualise a lumbar disc herniation

Question 8

Risk factors for lumbosacral radiculopathy (sciatica)

2

Answer 8

Age

Job that requires regular heavy lifting