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  Česky / Czech version Čes. a Slov. Neurol. Neurochir., 62/95, No. 3. p. 158–162.
 
Do We Diagnose Correctly Muscular Weakness in Radicular Syndrome? 
Mazanec R., Horáček O. 1 , Bojar M. 

 


Summary:

       Muscular weakness is part of the group of symptoms of the radicular syndrome. The weakness of some muscle groups is frequently diagnosed and sometimes it is the clinically dominant manifestation of the radicular syndrome. Weakening of other muscle groups is less striking and must be actively detected. This fact was verified in a group of 15 patients with radicular syndrome of L5, where as a rule in particular the weakness of the extensors of the foot and fingers is striking and to a lesser extent weakness of the abductors of the hip joint. In all patients CT examination confirmed prolapse of a disk or its sequester as the cause of the neurogenic lesion of the root of L5. EMG examination confirmed a neurogenic lesion as the cause of muscular weakness. In nine patients clinical examination revealed and electromyography confirmed weakness of the extensors of the foot and fingers as well as abductors of the hip joint. In three patients only weakness of the extensors of the foot and fingers. In three patients there was only weakness of the abductors of the hip joint. Weakness of the abductors of the hip joint is important for the development and persistence of impaired statics of the pelvis and spine. Within the framework of comprehensive rehabilitation it is necessary for promotion of the trophics of weak muscles to include as soon as possible facilitating elements. Early diagnosis and aimed rehabilitation of the weak muscles is the prerequisite of successful treatment of vertebrogenic complaints not only in compressive radicular syndromes but also in conditions after surgery of prolapses of intervertebral disks. It is always necessary to evaluate the postural disorder in conjunction with the clinical finding, muscle test, CT and EMG examination.

        Key words: compressive L5 radiculopathy, muscle test, electromyography, CT, prolapse of interverteb- ral disk
       

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