- Lumbar radicular symptoms may NOT follow classically accepted dermatome charts.
BACKGROUND & OBJECTIVE
Musculoskeletal therapists are routinely taught in bio-patho-anatomical dominant training to correlate dermatomal patterns to clinical presentations, under the assumption that lumbar radicular symptoms are evoked by ectopic discharges originating from a dorsal root or a dorsal root ganglion. Despite this, a regular clinical finding is of patients reporting non-dermatomal radicular symptoms.
Interventional radiology is another domain in which the lack of correlation between imaging findings, leg pain symptoms and dermatomal maps has been noted. Similar issues have been found and studied more extensively in the cervical spine (1). In fact, there has been some doubt about the validity of commonly promoted dermatome maps for some time (2,6).
Surprisingly, this was the first study to characterize potential lumbosacral radicular symptom referral patterns induced by mechanical and chemical irritation of lumbosacral nerve roots during transforaminal epidural injections.
Symptoms often do not fit into distinct dermatome distributions.
71 participants (38 male, 33 female, average age 63, prior lumbar spine surgery 31%) undergoing 125 fluoroscopically guided lumbosacral transforaminal epidural injections at an outpatient interventional spine practice were included. The patients recorded provoked symptoms onto body charts: 1) after