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Coexisting Upper Lumbar-Disc Herniation and Lumbosacral Radiculoplexus Neuropathy: A Diagnostic Challenge

A Case Report

Balachandar, Gopalan, MBBS, D(Orth), DNB(Orth)1

doi: 10.2106/JBJS.CC.N.00196
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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.

1Department of Orthopedics, Chettinad Hospital and Research Institute, Rajiv Gandhi Salai (OMR, Chennai), Kelambakkam, Kancheepuram District, Tamil Nadu 603 103, India. E-mail address: drbala8782@gmail.com

Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated
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