Characteristics of L3 nerve root radiculopathy.
BACKGROUND
In degenerative lumbar spinal disease with nerve root compression, the L5 and S1 nerve roots are the most often affected and the L3 nerve root is involved infrequently. The purpose of this study was to investigate the characteristics of L3 nerve root radiculopathy.


METHODS
Seventeen consecutive patients with L3 radiculopathy were treated. The symptomatic nerve roots were determined by the pain distribution, the neurologic findings, and selective nerve root injection. The clinical characteristics and outcomes of these patients were assessed retrospectively.


RESULTS
The average age was 76 years. The spinal diseases that were associated with L3 radiculopathy were lumbar canal stenosis in 6 patients, lumbar extraforaminal stenosis and lumbar disk herniation in 5 each, and lumbar canal stenosis with degenerative scoliosis in 1. The patients' symptoms were thigh pain in 12 patients, and hip or knee pain in 5. Four patients were nonambulatory because of severe pain. Although a sensory disturbance was reported in 9 patients, motor weakness was present in 2. Selective nerve root injection was completely effective in 10 patients. Six had decompressive surgery and/or fusion followed by a favorable outcome. Four patients were misdiagnosed and received conservative treatment for hip and/or knee joint diseases.


CONCLUSIONS
L3 radiculopathy was characterized by various lower limb pain and neurologic deficit. Selective nerve root injection was effective for most patients. In elderly patients who do not respond to treatment for hip and/or knee joint diseases, L3 nerve root radiculopathy should be considered as the cause of lower limb pain.
Hirabayashi
Hiroki
H
Department of Orthopedic Surgery, Shinshu University School of Medicine, Nagano, Japan.
Takahashi
Jun
J
Hashidate
Hiroyuki
H
Ogihara
Nobuhide
N
Tashiro
Atsutoshi
A
Misawa
Hiromichi
H
Ebara
Sohei
S
Mitsui
Katsuhiro
K
Wakabayashi
Shinji
S
Kato
Hiroyuki
H
D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019299:Decompression, Surgical / Q000379:methods / Q000706:statistics & numerical data; D017586:Diskectomy / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods / Q000706:statistics & numerical data; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000473:pathology / Q000601:surgery; D008012:Lidocaine / Q000627:therapeutic use; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology / Q000628:therapy; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D059408:Pain Management; D011843:Radiculopathy / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods / Q000706:statistics & numerical data; D013126:Spinal Nerve Roots / Q000473:pathology* / Q000503:physiopathology; D013130:Spinal Stenosis / Q000150:complications / Q000473:pathology / Q000601:surgery; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D013256:Steroids; D008012:Lidocaine