Approach to acute lumbosacral radiculopathy

MRI: magnetic resonance imaging; CT: computed tomography; CSF: cerebrospinal fluid.

* Clinical features of acute lumbosacral radiculopathy include low back pain with radiation to the leg or the groin; corresponding sensory abnormalities, weakness, or bowel/bladder dysfunction may or may not be present.

¶ If a primary neurologic cause is suspected from evaluation of symptoms, exam findings, or clinical course, additional testing may include:

• CSF analysis via lumbar puncture to evaluate for an inflammatory or infectious cause.
• Nerve conduction studies with electromyography (EMG) to evaluate for a peripheral nerve process.
• Additional neuroimaging to evaluate for spinal cord infarct or arteriovenous malformation.

Refer to the UpToDate topic on pathophysiology, clinical features, and diagnosis of acute lumbosacral radiculopathy, sections on evaluation and diagnosis.