FEMORAL NEURALGIA DUE TO DEGENERATIVE SPINAL-DISEASE - A RETROSPECTIVE CLINICAL AND RADIO-ANATOMICAL STUDY OF 100 CASES

We report a study of 100 patients admitted to the Grenoble Regional Te aching Hospital between July 1985 and February 1994 for femoral neural gia due to degenerative spinal disease. A herniated disk resulting in nerve root impingement was found in 79 patients (83 herniated disks) a nd lumbar spinal stenosis in 21. The level of nerve root compromise wa s L2-L3 in eight cases, L3-L4 in 35 cases, and L4-L5 in 40 cases. Hern iated disks were divided into several groups based on their location w ith regard to the intervertebral foramen: posterolateral herniations w ere entirely contained within the spinal canal (n=12; 14.5%), whereas far lateral, or foraminal, herniations (n=71; 85.5%) involved the inte rvertebral foramen. Twenty-nine foraminal herniations (34.9%) had a co mponent located within the spinal canal (medioforaminal herniations), 33 (39.8%) were entirely contained within the foramen (pure foraminal herniations), and nine (10.8%) were located lateral to the foramen (la teroforaminal herniations). As compared with posterolateral herniation s, foraminal herniations were associated with shorter symptom duration at admission (p<0.05), a greater likelihood of nocturnal exacerbation of pain (p<0.001) and of a positive femoral stretch test (p<0.01), an d failure of the pain to worsen during Valsalva maneuvers (p<0.01).