Spine: Radiculopathy

Question 1

Definition

Answer 1

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

Also known as sciatica

Question 2

Aetiology

Answer 2

• Most commonly caused by a disc herniation

• Other causes:
o Spinal stenosis
o Spondylolisthesis
o Spinal injury or infection
o Tumour
o Cauda equina syndrome

Question 3

Risk factors

Answer 3

o Age - older people are more like to get slipped discs

o Job that requires regular heavy lifting

Question 4

Epidemiology

Answer 4

• Relatively COMMON

* More common in MALES

Question 5

Presenting symptoms and signs on physical examination

Answer 5

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

Question 6

Investigations

Answer 6

• CLINICAL diagnosis

• Straight Leg Raise
o If pain in the distribution of the sciatic nerve is reproduced on passive flexion of the straight leg at the hip between 30-70 degrees then it is considered a positive
sign (Lasegue’s sign)
o This test is sensitive but not very specific

• CT/MRI - helps visualise a lumbar disc herniation