Femoral neuralgia due to degenerative spinal disease. A retrospective clinical and radio-anatomical study of one hundred cases.
We report a study of 100 patients admitted to the Grenoble Regional Teaching Hospital between July 1985 and February 1994 for femoral neuralgia due to degenerative spinal disease. A herniated disk resulting in nerve root impingement was found in 79 patients (83 herniated disks) and lumbar spinal stenosis in 21. The level of nerve root compromise was L2-L3 in eight cases, L3-L4 in 35 cases, and L4-L5 in 40 cases. Herniated disks were divided into several groups based on their location with regard to the intervertebral foramen: posterolateral herniations were entirely contained within the spinal canal (n = 12; 14.5%), whereas far lateral, or foraminal, herniations (n = 71; 85.5%) involved the intervertebral foramen. Twenty-nine foraminal herniations (34.9%) had a component located within the spinal canal (medioforaminal herniations), 33 (39.8%) were entirely contained within the foramen (pure foraminal herniations), and nine (10.8%) were located lateral to the foramen (lateroforaminal herniations). As compared with posterolateral herniations, foraminal herniations were associated with shorter symptom duration at admission (p < 0.05), a greater likelihood of nocturnal exacerbation of pain (p < 0.001) and of a positive femoral stretch test (p < 0.01), and failure of the pain to worsen during Valsalva maneuvers (p < 0.01).
Asquier
C
C
Rheumatology Department, Grenoble Teaching Hospital, France.
Troussier
B
B
Chirossel
J P
JP
Chardonnet
E
E
Mouries
D
D
Juvin
R
R
Phelip
X
X
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005267:Femoral Nerve / Q000000981:diagnostic imaging*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging*; D009437:Neuralgia / Q000000981:diagnostic imaging*; D009460:Neurologic Examination; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging*; D013130:Spinal Stenosis / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed