Corpus3D

Spine

Lumbosacral radicular syndrome

Mechanism
Irritation or compression of a lumbosacral nerve root, usually from a disc herniation bulging posterolaterally and affecting the root that leaves the foramen one level lower.
Recognition
The guideline defines LRS as pain in the buttock or radiating into the leg, with one or more features pointing to a specific root: paraesthesia, hypaesthesia, paresis or reduced reflexes. The neurological examination covers pain distribution, finger-floor distance, Lasègue's test, muscle strength, sensation and reflexes.
Course
A finger-floor distance of more than 25 centimetres counts as positive in the guideline. With severe motor loss (MRC score 3 or lower) or severe pain (NPRS 8 or higher) referral to the general practitioner follows; other patients are reassessed after two to four days.
What the guideline recommends
The guideline requires a neurological examination whenever LRS is suspected, and alertness to features of a serious neurological problem. Widespread neurological symptoms or pyramidal signs belong to a neurological emergency.

Structures

Joints involved

Clinical tests

Sources