Nondiscogenic Sciatica Syndrome, a Report on 41 Patients.

Abstract

41 patients with clinical features of discogenic sciatica during the last 25 years, proved later on by investigations and imaging to be a nondiscogenic in origin, The aim of the study is to inform spinal surgeons of possible differential diseases that mimic discogenic sciatica. All patients present clinically with a sciatica. They were recorded and treated accordingly and sent for investigations. Patients proved to have discogenic sciatica were excluded. Others further investigated and followed until finding a cause for the symptoms and recorded as nondiscogenic sciatica syndrome. 22 individual aetiologies were found to cause nondiscogenic including infectious, traumatic, oncogenic, degenerative, metabolic and ischemic causes. In conclusion a proper history and thorough physical examination, in addition to imaging and investigations were very useful in detecting the exact etiology of sciatica. The pain pattern and the related clinical features were the guide for the diagnosis. High index of suspicion is vital to achieve the definite diagnosis to avoid missing the diagnosis of nondiscogenic sciatica. One should maintain a high index of suspicion in patients with intractable sciatica.