Double Crush Syndrome in the Lower Extremity: Simultaneous L5 Radiculopathy and Common Peroneal Nerve Compression

Area of Science:

• Neurology
• Orthopedic Surgery
• Neurosurgery

Background:

• Double crush syndrome (DCS) describes nerve compression at multiple locations.
• A proximal lumbar spine lesion combined with distal common peroneal nerve entrapment can cause compound nerve dysfunction.

Purpose of the Study:

• To investigate the outcomes of common peroneal nerve decompression in patients with double crush syndrome involving L5 radiculopathy and peroneal mononeuropathy.

Main Methods:

• Retrospective analysis of 100 patients with L5 radiculopathy undergoing common peroneal nerve decompression.
• Inclusion criteria: active L5 radiculopathy and peroneal mononeuropathy (EMG/imaging).
• Focus on 10 patients with "pure" lower extremity DCS.

Main Results:

• All 10 patients with lower extremity DCS underwent common peroneal nerve decompression.
• Post-decompression, dorsiflexion, extensor hallucis longus strength, and ankle eversion improved.
• Numbness in the lateral leg/dorsal foot decreased, and positive Tinel's sign reduced.

Conclusions:

• This study reports the first series on DCS with dual compression points in the lumbar spine and lower extremity, confirmed by EMG and imaging.
• Common peroneal nerve decompression effectively improved dorsiflexion strength in affected patients.