title: Diffuse age-related lumbar mri changes confound diagnosis of single (L5) root lesions.
abstract: BACKGROUND
  L5 radiculopathy has characteristic clinical and electrodiagnostic features including: radicular pain; weakness or denervation of hip abductors, ankle dorsiflexors, and inverters; and pre-ganglionic dorsal foot sensory loss. It is unknown how often patients with this distinctive clinical-electrodiagnostic presentation have isolated L5-root compression on neuroimaging or more widespread, possibly age-related, lumbar neuroforaminal or spinal stenosis.
  
  
  METHODS
  A study-blinded neuroradiologist quantitated lumbosacral neuroforaminal, lateral recess, and spinal stenosis in 26 consecutive patients with unilateral, clinically and EMG-ascertained L5 monoradiculopathy, and quantitated a global neuroforaminal and spinal stenosis score (SSS).
  
  
  RESULTS
  Only 9 patients (35%) had isolated L5-root compression, 14 (54%) had multi-root compression, and 3 (12%) had normal neuroimaging. Increasing age correlated with SSS, and the 9 patients with isolated L5-root compression were significantly younger than patients with multi-root involvement.
  
  
  CONCLUSIONS
  This study underscores the role of clinical and electrodiagnostic data when interpreting lumbosacral neuroimaging, particularly in older patients.
authors.affiliation: Department of Neurology and Neuroradiology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 673, Rochester, New York, 14642, USA.
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Botez
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Zynda-Weiss
authors.forename: Eric L
authors.initials: EL
authors.lastname: Logigian
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D004568:Electrodiagnosis; D004576:Electromyography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008161:Lumbosacral Region / Q000502:physiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis; D009431:Neural Conduction; D011843:Radiculopathy / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D013126:Spinal Nerve Roots / Q000473:pathology*; D013130:Spinal Stenosis / Q000175:diagnosis / Q000473:pathology; D013131:Spine / Q000473:pathology
keywords: L5; MRI; aging; foraminal stenosis; lumbar radiculopathy; spinal stenosis