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Chapter 11 - Painful conditions affecting the nerve roots and plexus

from Section 3 - The Specific Condition: Peripheral Neuropathic Pain

Published online by Cambridge University Press:  05 December 2013

Cory Toth
Affiliation:
Department of Neurology, University of Calgary
Dwight E. Moulin
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario
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Summary

Nerve root compression can occur from osteophyte formation, disc herniation, or a combination. As only 1-2% of patients with back pain have a nerve root or spinal cord compression, an accurate diagnosis of the causes of painful radiculopathy relies on a thorough history and physical exam. It is important to note that many asymptomatic individuals have abnormalities such as disc herniations and foraminal stenosis on CT and MRI. Therefore, the imaging findings must be correlated with the history and examination findings. Surgery for spinal stenosis and neurogenic claudication is indicated if severe pain is present, and can provide sustained relief. Since the spinal cord terminates at the L1-2 vertebral level, lumbar pathology below this level may compress the distal nerve root, causing a cauda equina syndrome. A lesion affecting the lumbosacral plexus (LSP) can present with pain in the low back, hip or pelvis, or with sciatica pain.
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Neuropathic Pain
Causes, Management and Understanding
, pp. 130 - 144
Publisher: Cambridge University Press
Print publication year: 2013

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