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Coexisting Upper Lumbar-Disc Herniation and Lumbosacral Radiculoplexus Neuropathy: A Diagnostic Challenge: A Case
1Department of Orthopedics, Chettinad Hospital and Research Institute, Rajiv Gandhi Salai (OMR, Chennai), Kelambakkam, Kancheepuram District, Tamil Nadu 603 103, India. drbala8782@gmail.com.
Case:
An elderly man presented with nontraumatic, acute onset of paralysis of the right quadriceps and the hip flexors, adductors, and abductors without backache or signs of nerve-root tension. Magnetic resonance imaging showed evidence of upper lumbar-disc extrusion with foraminal stenosis as well as right-sided inflammatory lumbar plexitis involving the L2, L3, and L4 nerve roots. However, the pattern of neurological involvement and relatively rapid and full recovery following treatment with parenteral corticosteroids suggested a diagnosis of chemical radiculitis.
Conclusion:
It is important to differentiate chemical radiculitis from both lumbar plexopathy and a herniated nucleus pulposus because it can be treated nonoperatively, with the expectation of a relatively rapid and full recovery.
