Animation: Lumbar neurography for evaluation of sciatica of non-disc origin. Distal foraminal lumbar nerve root entrapment.
(A) Normal anatomy of the L3, L4 and proximal L5 nerve roots and lumbar spinal nerves as they exit the spine traveling in essentially linear fashion.
(B) Exiting right L5 nerve root (*) of 65-year-old woman with persistent right L5 radiculopathy after two spine surgeries. The course of the exiting root is distorted; there exists both focal narrowing and a region of hyperintensity (n).
(C) Myelogram of same patient obtained just prior to MR Neurography. The L5 root abnormality is too distal to be appreciated in the myelogram (*) and the study was read as showing a normal L5 root with no impingement. After the Neurographic diagnosis, the patient had a distal foraminotomy with excellent lasting relief of her radiculopathy.