Differentiating Lumbar Spinal Etiology from Peripheral Plexopathies

Abstract

Clinicians have managed and treated lower back pain since the earliest days of practice. Historically, lower back pain and its accompanying symptoms of radiating leg pain and muscle weakness have been recognized to be due to any of the various lumbar spine pathologies that lead to the compression of the lumbar nerves at the root, the most common of which is the radiculopathy known as sciatica. More recently, however, with the increased rise in chronic diseases, the importance of differentially diagnosing a similarly presenting pathology, known as lumbosacral plexopathy, cannot be understated. Given the similar clinical presentation of lumbar spine pathologies and lumbosacral plexopathies, it can be difficult to differentiate these two diagnoses in the clinical setting. Resultingly, the inappropriate diagnosis of either pathology can result in ineffective clinical management. Thus, this review aims to aid in the clinical differentiation between lumbar spine pathology and lumbosacral plexopathy. Specifically, this paper delves into spine and plexus anatomy, delineates the clinical assessment of both pathologies, and highlights powerful diagnostic tools in the hopes of bolstering appropriate diagnosis and treatment. Lastly, this review will describe emerging treatment options for both pathologies in the preclinical and clinical realms, with a special emphasis on regenerative nerve therapies.

A very rare complication after knee arthroplasty: a case description of postoperative acute paraplegia

“…However, in clinical practice, paraplegia needs to be differentiated from plexopathy. The clinical presentations of lumbar spondylosis and plexopathy are highly similar, with the most common symptom of lumbar spondylosis being bilateral leg pain, but the common symptom in patients with plexopathy is unilateral radiation ( 21 ). If the clinical symptoms do not improve significantly, an MRI examination reveals no significant improvement in spinal edema, and an abnormal vascular shadow is observed in the spinal canal, cerebral and spinal angiography should be performed to confirm the type of lesion.…”

Deletion of endothelial IGFBP5 protects against ischaemic hindlimb injury by promoting angiogenesis

“… 1 , 2 , 3 , 4 The condition of CLI is associated with disabled quality of life as well as early cardiovascular and non‐cardiovascular mortality. 5 , 6 , 7 , 8 Former studies have shown that adeno‐associated viral vector treatment improved survival, motor function and developmental milestones in numerous neural or vascular patients. 9 , 10 Thus, it is urgent to develop treatment approaches to eliminate the growth of CLI in patients 11 and accelerate angiogenesis of ischaemic tissue to restore blood supply.…”

Combined Treatments and Therapies to Cure Spinal Cord Injury

“…Finally, the last review by Foreman et al focuses on lower back pain and clinically presents the various pathologies that can lead to these chronic pains. They also introduce new therapeutic approaches that could help manage these types of pathologies, including neuromodulation and cell transplantation [30].…”