Abstract
Lumbosacral radiculopathy and low back pain are common medical problems. Patients with low back and/or leg pain are often suspected of having lumbosacral nerve root compression and referred to neurologists, neuromuscular specialists, and/or electrodiagnostic laboratories. This chapter reviews the clinical spectrum of lumbosacral and thoracic radiculopathies, including relevant anatomic and pathophysiologic considerations, diagnosis, management, and prognosis.
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References
Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med. 1934;211:210–7.
Love JG, Kiefer EJ. Root pain and paraplegia due to protrusions of thoracic intervertebral disks. J Neurosurg. 1950;7(1):62–9, illust.
Moore KL. Clinically oriented anatomy. Baltimore: The Williams & Wilkins Company; 1980. p. 605–73.
Stewart JD. The cauda equina, lumbar and sacral nerve roots, and spinal nerves. In: Focal peripheral neuropathies. 1st ed. New York: Elsevier Science Publishing Company; 1987. p. 218–69.
Hardy RW, Plank NM. Clinical diagnosis of herniated lumbar disc. In: Hardy RW, editor. Lumbar disc disease. New York: Raven Press; 1982. p. 17–28.
Fager CA. Surgical approaches to lumbar disk lesions and spondylosis. Surg Clin North Am. 1980;60:649–63.
Stewart JD. The thoracic spinal nerves. In: Focal peripheral neuropathies. 1st ed. New York: Elsevier Science Publishing Company; 1987. p. 349–58.
Sunderland S. Nerves and nerve injuries. 2nd ed. New York: Churchill Livingstone; 1978.
Rydevik B, Brown MD, Lundborg G. Pathoanatomy and pathophysiology of nerve root compression. Spine (Phila Pa 1976). 1984;9(1):7–15.
Saal JS, Franson RC, Dobrow R, Saal JA, White AH, Goldthwaite N. High levels of inflammatory phospholipase A2 activity in lumbar disc herniations. Spine (Phila Pa 1976). 1990;15(7):674–8.
Rydevik B, Holm S, Brown MD, Lundborg G. Diffusion from the cerebrospinal fluid as a nutritional pathway for spinal nerve roots. Acta Physiol Scand. 1990;138(2):247–8.
Deville WL, van der Windt DA, Dzaferagic A, Bezemer PD, Bouter LM. The test of Lasegue: systematic review of the accuracy in diagnosing herniated discs. Spine (Phila Pa 1976). 2000;25(9):1140–7.
Van Boxem K, Cheng J, Patijn J, et al. 11. Lumbosacral radicular pain. Pain Pract. 2010;10(4):339–58.
Watson J. Office evaluation of spine and limb pain: spondylotic radiculopathy and other nonstructural mimickers. Semin Neurol. 2011;31(1):85–101.
Gleave JR, MacFarlane R. Prognosis for recovery of bladder function following lumbar central disc prolapse. Br J Neurosurg. 1990;4(3):205–9.
Binder DK, Schmidt MH, Weinstein PR. Lumbar spinal stenosis. Semin Neurol. 2002;22(2):157–66.
Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N Engl J Med. 2008;358(8):818–25.
Katz JN, Dalgas M, Stucki G, et al. Degenerative lumbar spinal stenosis. Diagnostic value of the history and physical examination. Arthritis Rheum. 1995;38(9):1236–41.
Kirkaldy-Willis WH WJ, Yong-Hing K, Reilly J. Pathology and pathogenesis of lumbar spondylosis and stenosis. Spine (Phila Pa 1976). 1978;3(4):319–28.
Brown CW, Deffer Jr PA, Akmakjian J, Donaldson DH, Brugman JL. The natural history of thoracic disc herniation. Spine (Phila Pa 1976). 1992;17(6 Suppl):S97–102.
Stillerman CB, Chen TC, Couldwell WT, Zhang W, Weiss MH. Experience in the surgical management of 82 symptomatic herniated thoracic discs and review of the literature. J Neurosurg. 1998;88(4):623–33.
Batzdorf V, Selch M. Spinal cord tumors. In: Haskell CM, editor. Cancer treatment, vol. 802–9. 4th ed. Philadelphia: WB Saunders Co; 1995.
Black P. Spinal metastasis: current status and recommended guidelines for management. Neurosurgery. 1979;5(6):726–46.
Ushio Y, Posner R, Posner JB, Shapiro WR. Experimental spinal cord compression by epidural neoplasm. Neurology. 1977;27(5):422–9.
Engelhard HH, Villano JL, Porter KR, et al. Clinical presentation, histology, and treatment in 430 patients with primary tumors of the spinal cord, spinal meninges, or cauda equina. J Neurosurg Spine. 2010;13(1)):67–77.
Van Goethem JW, van den Hauwe L, Ozsarlak O, De Schepper AM, Parizel PM. Spinal tumors. Eur J Radiol. 2004;50(2):159–76.
Fearnside MR, Adams CB. Tumours of the cauda equina. J Neurol Neurosurg Psychiatry. 1978;41(1):24–31.
Schutta H. Spinal tumors. In: Joynt RJ GR, editor. Clinical neurology. Philadelphia: Lippincott Williams & Wilkins; 1994. p. 1–126.
Taylor JW, Schiff D. Metastatic epidural spinal cord compression. Semin Neurol. 2010;30(3):245–53.
Posner J. Neurologic complications of cancer. Philadelphia: F.A. Davis Company; 1995.
Byrne TN. Spinal cord compression from epidural metastases. N Engl J Med. 1992;327(9):614–9.
Gilbert RW, Kim JH, Posner JB. Epidural spinal cord compression from metastatic tumor: diagnosis and treatment. Ann Neurol. 1978;3(1):40–51.
Grant R, Papadopoulos SM, Greenberg HS. Metastatic epidural spinal cord compression. Neurol Clin. 1991;9(4):825–41.
DeAngelis LM, Boutros D. Leptomeningeal metastasis. Cancer Invest. 2005;23(2):145–54.
Chamberlain MC. Leptomeningeal metastasis. Semin Neurol. 2009;30(3):236–44.
Little JR, Dale AJ, Okazaki H. Meningeal carcinomatosis. Clinical manifestations. Arch Neurol. 1974;30(2):138–43.
O’Meara WP, Borkar SA, Stambuk HE, Lymberis SC. Leptomeningeal metastasis. Curr Probl Cancer. 2007;31(6):367–424.
Grossman SA, Krabak MJ. Leptomeningeal carcinomatosis. Cancer Treat Rev. 1999;25(2):103–19.
Straathof CS, de Bruin HG, Dippel DW, Vecht CJ. The diagnostic accuracy of magnetic resonance imaging and cerebrospinal fluid cytology in leptomeningeal metastasis. J Neurol. 1999;246(9):810–4.
Thomas JE, Howard Jr FM. Segmental zoster paresis – a disease profile. Neurology. 1972;22(5):459–66.
Dubinsky RM, Kabbani H, El-Chami Z, Boutwell C, Ali H. Practice parameter: treatment of postherpetic neuralgia: an evidence-based report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2004;63(6):959–65.
Cluff RS, Rowbotham MC. Pain caused by herpes zoster infection. Neurol Clin. 1998;16(4):813–32.
Alshekhlee A, Tay E, Buczek M, Shakir ZA, Katirji B. Herpes zoster with motor involvement: discordance between the distribution of skin rash and localization of peripheral nervous Âsystem dysfunction. J Clin Neuromuscul Dis. 2011;12(3):153–7.
Hlavin ML, Kaminski HJ, Fenstermaker RA, White RJ. Intracranial suppuration: a modern decade of postoperative subdural empyema and epidural abscess. Neurosurgery. 1994;34(6):974–80; discussion 980–1.
Schutta H. Diseases of the dura mater. In: Joynt RJ GR, editor. Clinical neurology. Philadelphia: Lippincott Williams & Wilkins; 1993. p. 67–91.
Del Curling Jr O, Gower DJ, McWhorter JM. Changing concepts in spinal epidural abscess: a report of 29 cases. Neurosurgery. 1990;27(2):185–92.
Cohen DB. Infectious origins of cauda equina syndrome. Neurosurg Focus. 2004;16(6):e2.
So YT, Olney RK. Acute lumbosacral polyradiculopathy in acquired immunodeficiency syndrome: experience in 23 patients. Ann Neurol. 1994;35(1):53–8.
Corral I, Quereda C, Casado JL, et al. Acute polyradiculopathies in HIV-infected patients. J Neurol. 1997;244(8):499–504.
Anders HJ, Goebel FD. Cytomegalovirus polyradiculopathy in patients with AIDS. Clin Infect Dis. 1998;27(2):345–52.
Verma S, Micsa E, Estanislao L, Simpson D. Neuromuscular complications in HIV. Curr Neurol Neurosci Rep. 2004;4(1):62–7.
O’Connell S. Lyme borreliosis: current issues in diagnosis and management. Curr Opin Infect Dis. 2010;23(3):231–5.
Logigian EL. Peripheral nervous system Lyme borreliosis. Semin Neurol. 1997;17(1):25–30.
Halperin JJ. Lyme disease and the peripheral nervous system. Muscle Nerve. 2003;28(2):133–43.
Logigian EL, Steere AC. Clinical and electrophysiologic findings in chronic neuropathy of Lyme disease. Neurology. 1992;42(2):303–11.
Bastron JA, Thomas JE. Diabetic polyradiculopathy: clinical and electromyographic findings in 105 patients. Mayo Clin Proc. 1981;56(12):725–32.
Dyck PJ, Windebank AJ. Diabetic and nondiabetic lumbosacral radiculoplexus neuropathies: new insights into pathophysiology and treatment. Muscle Nerve. 2002;25(4):477–91.
Kane RE. Neurologic deficits following epidural or spinal anesthesia. Anesth Analg. 1981;60(3):150–61.
Yuen EC, Layzer RB, Weitz SR, Olney RK. Neurologic complications of lumbar epidural anesthesia and analgesia. Neurology. 1995;45(10):1795–801.
Horlocker TT. Complications of spinal and epidural anesthesia. Anesthesiol Clin North America. 2000;18(2):461–85.
Brull R, McCartney CJ, Chan VW, El-Beheiry H. Neurological complications after regional anesthesia: contemporary estimates of risk. Anesth Analg. 2007;104(4):965–74.
Esses SI, Morley TP. Spinal arachnoiditis. Can J Neurol Sci. 1983;10(1):2–10.
Aufschnaiter K, Fellner F, Wurm G. Surgery in adult onset tethered cord syndrome (ATCS): review of literature on occasion of an exceptional case. Neurosurg Rev. 2008;31(4):371–83.
Pang D, Wilberger Jr JE. Tethered cord syndrome in adults. J Neurosurg. 1982;57(1):32–47.
Benny BV, Nagpal AS, Singh P, Smuck M. Vascular causes of radiculopathy: a literature review. Spine J. 2011;11(1):73–85.
Paksoy Y, Gormus N. Epidural venous plexus enlargements presenting with radiculopathy and back pain in patients with inferior vena cava obstruction or occlusion. Spine (Phila Pa 1976). 2004;29(21):2419–24.
Goldstein JM, Parks BJ, Mayer PL, Kim JH, Sze G, Miller RG. Nerve root hypertrophy as the cause of lumbar stenosis in chronic inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve. 1996;19(7):892–6.
Rosen SA, Wang H, Cornblath DR, Uematsu S, Hurko O. Compression syndromes due to hypertrophic nerve roots in hereditary motor sensory neuropathy type I. Neurology. 1989;39(9):1173–7.
Fogel GR, Cunningham 3rd PY, Esses SI. Spinal epidural lipomatosis: case reports, literature review and meta-analysis. Spine J. 2005;5(2):202–11.
Koffman B, Junck L, Elias SB, Feit HW, Levine SR. Polyradiculopathy in sarcoidosis. Muscle Nerve. 1999;22(5):608–13.
Aminoff MJ, Goodin DS, Parry GJ, Barbaro NM, Weinstein PR, Rosenblum ML. Electrophysiologic evaluation of lumbosacral radiculopathies: electromyography, late responses, and somatosensory evoked potentials. Neurology. 1985;35(10):1514–8.
Nardin RA, Patel MR, Gudas TF, Rutkove SB, Raynor EM. Electromyography and magnetic resonance imaging in the evaluation of radiculopathy. Muscle Nerve. 1999;22(2):151–5.
Khatri BO, Baruah J, McQuillen MP. Correlation of electromyography with computed tomography in evaluation of lower back pain. Arch Neurol. 1984;41(6):594–7.
Kuruoglu R, Oh SJ, Thompson B. Clinical and electromyographic correlations of lumbosacral radiculopathy. Muscle Nerve. 1994;17(2):250–1.
Tonzola RF, Ackil AA, Shahani BT, Young RR. Usefulness of electrophysiological studies in the diagnosis of lumbosacral root disease. Ann Neurol. 1981;9(3):305–8.
Dumitru D, Dreyfuss P. Dermatomal/segmental somatosensory evoked potential evaluation of L5/S1 unilateral/unilevel radiculopathies. Muscle Nerve. 1996;19(4):442–9.
Modic MT, Masaryk T, Boumphrey F, Goormastic M, Bell G. Lumbar herniated disk disease and canal stenosis: prospective evaluation by surface coil MR, CT, and myelography. Am J Roentgenol. 1986;147(4):757–65.
Wilbourn AJ, Aminoff MJ. AAEM minimonograph 32: the electrodiagnostic examination in patients with radiculopathies. American Association of Electrodiagnostic Medicine. Muscle Nerve. 1998;21(12):1612–31.
Berger AR, Sharma K, Lipton RB. Comparison of motor conduction abnormalities in lumbosacral radiculopathy and axonal polyneuropathy. Muscle Nerve. 1999;22(8):1053–7.
Levin KH. L5 radiculopathy with reduced superficial peroneal sensory responses: intraspinal and extraspinal causes. Muscle Nerve. 1998;21(1):3–7.
Levin KH, Maggiano HJ, Wilbourn AJ. Cervical radiculopathies: comparison of surgical and EMG localization of single-root lesions. Neurology. 1996;46(4):1022–5.
Nardin RA, Raynor EM, Rutkove SB. Fibrillations in lumbosacral paraspinal muscles of normal subjects. Muscle Nerve. 1998;21(10):1347–9.
Sheehan NJ. Magnetic resonance imaging for low back pain: indications and limitations. Postgrad Med J. 2010;86(1016):374–8.
Bischoff RJ, Rodriguez RP, Gupta K, Righi A, Dalton JE, Whitecloud TS. A comparison of computed tomography-myelography, magnetic resonance imaging, and myelography in the diagnosis of herniated nucleus pulposus and spinal stenosis. J Spinal Disord. 1993;6(4):289–95.
Bartynski WS, Lin L. Lumbar root compression in the lateral recess: MR imaging, conventional myelography, and CT myelography comparison with surgical confirmation. AJNR Am J Neuroradiol. 2003;24(3):348–60.
Kent DL, Haynor DR, Larson EB, Deyo RA. Diagnosis of lumbar spinal stenosis in adults: a metaanalysis of the accuracy of CT, MR, and myelography. Am J Roentgenol. 1992;158(5):1135–44.
Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2):69–73.
Seidenwurm D, Russell EJ, Hambly M. Diagnostic accuracy, patient outcome, and economic factors in lumbar radiculopathy. Radiology. 1994;190(1):21–5; discussion 25–30.
Boden SD. The use of radiographic imaging studies in the evaluation of patients who have degenerative disorders of the lumbar spine. J Bone Joint Surg Am. 1996;78:114–24.
Georgy BA, Snow RD, Hesselink JR. MR imaging of spinal nerve roots: techniques, enhancement patterns, and imaging findings. AJR Am J Roentgenol. 1996;166(1):173–9.
Ross JS, Modic MT. Current assessment of spinal degenerative disease with magnetic resonance imaging. Clin Orthop Relat Res. 1992;279:68–81.
Hitselberger WE, Witten RM. Abnormal myelograms in asymptomatic patients. J Neurosurg. 1968;28(3):204–6.
Wiesel SW, Tsourmas N, Feffer HL, Citrin CM, Patronas N. A study of computer-assisted tomography. I. The incidence of positive CAT scans in an asymptomatic group of patients. Spine (Phila Pa 1976). 1984;9(6):549–51.
Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72(3):403–8.
Boden SD, McCowin PR, Davis DO, Dina TS, Mark AS, Wiesel S. Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72(8):1178–84.
Wood KB, Garvey TA, Gundry C, Heithoff KB. Magnetic resonance imaging of the thoracic spine. Evaluation of asymptomatic individuals. J Bone Joint Surg Am. 1995;77(11):1631–8.
Modic MT, Obuchowski NA, Ross JS, et al. Acute low back pain and radiculopathy: MR imaging findings and their prognostic role and effect on outcome. Radiology. 2005;237(2):597–604.
Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine (Phila Pa 1976). 1983;8(2):131–40.
Hakelius A. Prognosis in sciatica. A clinical follow-up of surgical and non-surgical treatment. Acta Orthop Scand Suppl. 1970;129:1–76.
Hahne AJ, Ford JJ, McMeeken JM. Conservative management of lumbar disc herniation with associated radiculopathy: a systematic review. Spine (Phila Pa 1976). 2010;35(11):E488–504.
Gregory DS, Seto CK, Wortley GC, Shugart CM. Acute lumbar disk pain: navigating evaluation and treatment choices. Am Fam Physician. 2008;78(7):835–42.
Luijsterburg PA, Verhagen AP, Ostelo RW, van Os TA, Peul WC, Koes BW. Effectiveness of conservative treatments for the lumbosacral radicular syndrome: a systematic review. Eur Spine J. 2007;16(7):881–99.
Baron R, Freynhagen R, Tolle TR, et al. The efficacy and safety of pregabalin in the treatment of neuropathic pain associated with chronic lumbosacral radiculopathy. Pain. 2010;150(3):420–7.
Khoromi S, Cui L, Nackers L, Max MB. Morphine, nortriptyline and their combination vs. placebo in patients with chronic lumbar root pain. Pain. 2007;130(1–2):66–75.
Haimovic IC, Beresford HR. Dexamethasone is not superior to placebo for treating lumbosacral radicular pain. Neurology. 1986;36(12):1593–4.
Finckh A, Zufferey P, Schurch MA, Balague F, Waldburger M, So AK. Short-term efficacy of intravenous pulse glucocorticoids in acute discogenic sciatica. A randomized controlled trial. Spine (Phila Pa 1976). 2006;31(4):377–81.
Abdi S, Datta S, Trescot AM, et al. Epidural steroids in the management of chronic spinal pain: a systematic review. Pain Physician. 2007;10(1):185–212.
Bush K, Hillier S. A controlled study of caudal epidural injections of triamcinolone plus procaine for the management of intractable sciatica. Spine (Phila Pa 1976). 1991;16(5):572–5.
Bigos S, Braen G, et al. Acute low back problems in adults. Clinical practice guideline no. 14. Rockville: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services; 1994.
Weber H. The natural course of disc herniation. Acta Orthop Scand Suppl. 1993;251:19–20.
Hall H. Surgery: indications and options. Neurol Clin. 1999;17(1):113–30.
Wilson DH, Harbaugh R. Microsurgical and standard removal of the protruded lumbar disc: a comparative study. Neurosurgery. 1981;8(4):422–7.
Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA. 2006;296(20):2441–50.
Osterman H, Seitsalo S, Karppinen J, Malmivaara A. Effectiveness of microdiscectomy for lumbar disc herniation: a randomized controlled trial with 2 years of follow-up. Spine (Phila Pa 1976). 2006;31(21):2409–14.
Gibson JN, Waddell G. Surgical interventions for lumbar disc prolapse. Cochrane Database Syst Rev. 2007;(2):CD001350.
Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356(22):2245–56.
Paine KW. Results of decompression for lumbar spinal stenosis. Clin Orthop Relat Res. 1976;115:96–100.
Slatis P, Malmivaara A, Heliovaara M, et al. Long-term results of surgery for lumbar spinal stenosis: a randomised controlled trial. Eur Spine J. 2011;20(7):1174–81.
Atlas SJ, Keller RB, Wu YA, Deyo RA, Singer DE. Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the maine lumbar spine study. Spine (Phila Pa 1976). 2005;30(8):936–43.
Kaba SE, DeMonte F, Bruner JM, et al. The treatment of recurrent unresectable and malignant meningiomas with interferon alpha-2B. Neurosurgery. 1997;40(2):271–5.
Harrington KD. Metastatic disease of the spine. J Bone Joint Surg Am. 1986;68(7):1110–5.
Gabriel K, Schiff D. Metastatic spinal cord compression by solid tumors. Semin Neurol. 2004;24(4):375–83.
Sundaresan N, Krol G, Digiacinto G, Hughes J. Metastatic tumors of the spine. In: Sundaresan N, Schmidek HH, Schiller A, Rosenthal D, editors. Tumors of the spine: diagnosis and clinical management. Philadelphia: WB Saunders; 1990. p. 279–304.
Wasserstrom W. Leptomeningeal metastases. In: Wiley RG, editor. Neurological complications of cancer. New York: Marcel Dekker; 1995. p. 45–71.
Kost RG, Straus SE. Postherpetic neuralgia – pathogenesis, treatment, and prevention. N Engl J Med. 1996;335(1):32–42.
Choo PW, Galil K, Donahue JG, Walker AM, Spiegelman D, Platt R. Risk factors for postherpetic neuralgia. Arch Intern Med. 1997;157(11):1217–24.
Whitley RJ, Weiss H, Gnann Jr JW, et al. Acyclovir with and without prednisone for the treatment of herpes zoster. A randomized, placebo-controlled trial. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Ann Intern Med. 1996;125(5):376–83.
Dworkin RH, Johnson RW, Breuer J, et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007;44 Suppl 1Suppl 1:S1–26.
Wu CL, Raja SN. An update on the treatment of postherpetic neuralgia. J Pain. 2008;9(1 Suppl 1):S19–30.
Moore RA, Straube S, Wiffen PJ, Derry S, McQuay HJ. Pregabalin for acute and chronic pain in adults. Cochrane Database Syst Rev. 2009;(3):CD007076.
Oxman MN, Levin MJ. Vaccination against herpes zoster and postherpetic neuralgia. J Infect Dis. 2008;197 Suppl 2Suppl 2:S228–36.
Wilson JF. Herpes zoster. Ann Intern Med. 2011;154(5):ITC31–15; quiz ITC316.
Pradilla G, Ardila GP, Hsu W, Rigamonti D. Epidural abscesses of the CNS. Lancet Neurol. 2009;8(3):292–300.
Sendi P, Bregenzer T, Zimmerli W. Spinal epidural abscess in clinical practice. QJM. 2008;101(1):1–12.
Verma A. Epidemiology and clinical features of HIV-1 associated neuropathies. J Peripher Nerv Syst. 2001;6(1):8–13.
Halperin JJ, Shapiro ED, Logigian E, et al. Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2007;69(1):91–102.
Ljostad U, Skogvoll E, Eikeland R, et al. Oral doxycycline versus intravenous ceftriaxone for European Lyme neuroborreliosis: a multicentre, non-inferiority, double-blind, randomised trial. Lancet Neurol. 2008;7(8):690–5.
Mygland A, Ljostad U, Fingerle V, Rupprecht T, Schmutzhard E, Steiner I. EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. Eur J Neurol. 2010;17(1):8–16. e11–4.
Longstreth GF. Diabetic thoracic polyradiculopathy: ten patients with abdominal pain. Am J Gastroenterol. 1997;92(3):502–5.
Thaisetthawatkul P, Dyck PJ. Treatment of diabetic and nondiabetic lumbosacral radiculoplexus neuropathy. Curr Treat Options Neurol. 2010;12(2):95–9.
Roca J, Moreta D, Ubierna MT, Caceres E, Gomez JC. The results of surgical treatment of lumbar arachnoiditis. Int Orthop. 1993;17(2):77–81.
North RB, Kidd DH, Zahurak M, James CS, Long DM. Spinal cord stimulation for chronic, intractable pain: experience over two decades. Neurosurgery. 1993;32(3):384–94; discussion 394–5.
Martin RJ, Yuan HA. Neurosurgical care of spinal epidural, subdural, and intramedullary abscesses and arachnoiditis. Orthop Clin North Am. 1996;27(1):125–36.
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Raynor, E.M., Boruchow, S.A., Nardin, R., Kleiner-Fisman, G. (2014). Lumbosacral and Thoracic Radiculopathies. In: Katirji, B., Kaminski, H., Ruff, R. (eds) Neuromuscular Disorders in Clinical Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6567-6_45
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