Lumbar Pain Maps

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Lumbar Facet Joints

Lumbar Facet pain.PNG

From Manchikanti

Lumbar Interspinous Ligaments

Referred pain patterns from noxious stimulation of the lumbar interspinous ligaments. Kellgren 1939.

Lumbar Radicular Pain

Main article: Lumbar Radicular Pain

Sensory Deficit Maps with Nerve Block

In 1993 Nitta et al looked at dermatome patterns by doing fluoroscopically guided spinal nerve anaesthetic blocks in patients with radicular pain. They found the following sensory deficits.[1]

Inadvertent Pain Maps during TFI

Furman et al in 2019 mapped lower limb radicular symptoms based on inadvertent pain patterns during supraneural transforaminal injections, the data is modified in table format below. They confirmed that history and pain charts cannot predict the nerve root level. The buttock is a very common pain referral location across all nerve roots, while pain in the thigh and leg frequently follows dermatomal distributions. A significant limitation of the study is that injectate in transforaminal injections frequently traverses segment levels.[2]

Nerve Root L3 L4 L5 S1
Buttock 45% 43% 62% 64%
Groin 0% 3% 0% 0%
Anterior Thigh 27% 29% 12% 0%
Posterior Thigh 36% 25% 59% 36%
Medial Thigh 18% 11% 3% 0%
Lateral Thigh 0% 14% 9% 0%
Knee 9% 7% 6% 9%
Anterior Leg 0% 14% 3% 0%
Posterior Leg 18% 18% 50% 45%
Medial Leg 0% 7% 6% 0%
Lateral Leg 9% 14% 24% 0%
Foot 0% 3% 0% 0%

See Also

References

  1. Nitta et al.. Study on dermatomes by means of selective lumbar spinal nerve block. Spine 1993. 18:1782-6. PMID: 8235861. DOI.
  2. Furman & Johnson. Induced lumbosacral radicular symptom referral patterns: a descriptive study. The spine journal : official journal of the North American Spine Society 2019. 19:163-170. PMID: 29800710. DOI.