Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA.
Department of Neurosurgery, The George Washington University, 2150 Pennsylvania Avenue, NW, Suite 7-412, Washington, DC, 20037, USA.
Acta Neurochir (Wien). 2018 Nov;160(11):2225-2227. doi: 10.1007/s00701-018-3664-z. Epub 2018 Sep 10.
Diabetic lumbosacral radiculoplexus neuropathy is often confused with radiculopathy in the context of spinal degenerative disc disease including spinal stenosis. Accuracy in diagnosis may prevent unnecessary interventional procedures including selective nerve root blocks or epidural steroid injections or even surgery in selected cases. Our patient with known diabetes and lumbar disc disease presented with acute onset of pain in L5-S1 distribution of the left lower extremity. Initial MR imaging of the lumbar spine did not show sufficient structural changes to explain her symptomatology. An MR neurogram of the lumbosacral plexus revealed inflammation within the bilateral sciatic and femoral nerves; subsequent EMG demonstrated a generalized sensorimotor neuropathy but no evidence of plexopathy. To our knowledge, this is the first case report that utilized MR imaging of the pelvis to assist in the diagnosis of diabetic lumbosacral radiculoplexus neuropathy (DLRPN).
糖尿病性腰骶神经根丛神经病在脊柱退行性椎间盘疾病（包括椎管狭窄症）的背景下常与神经根病混淆。准确的诊断可以防止不必要的介入性手术，包括选择性神经根阻滞或硬膜外类固醇注射，甚至在某些情况下手术。我们的患者患有已知的糖尿病和腰椎间盘疾病，表现为左侧下肢 L5-S1 分布区的急性疼痛发作。腰椎的初始磁共振成像（MRI）没有显示出足够的结构变化来解释她的症状。腰骶丛磁共振神经成像显示双侧坐骨神经和股神经内有炎症；随后的肌电图显示广泛的感觉运动神经病，但没有丛病的证据。据我们所知，这是首例利用骨盆 MRI 协助诊断糖尿病性腰骶神经根丛神经病（DLRPN）的病例报告。
