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Radiation-induced lumbar plexopathy (RILP) or radiation-induced lumbosacral plexopathy (RILSP) is nerve damage in the pelvis and lower spine area caused by therapeutic radiation treatments. RILP is a rare side effect of external beam radiation therapy [ 1 ] [ 2 ] [ 3 ] and both interstitial and intracavity brachytherapy radiation implants.
If plexopathy is suspected after imaging, an EMG performed by a neurologist or physiatrist can help confirm a plexopathy, and clarify the localization within the brachial or lumbosacral plexus. Following electrodiagnostic testing, further imaging may be obtained of relevant soft tissue structures with either ultrasound or MRI .
It is part of the lumbosacral plexus and emerges from the lumbar vertebrae and sacral vertebrae (L4-S4). [1] A sacral plexopathy is a disorder affecting the nerves of the sacral plexus, usually caused by trauma, nerve compression, vascular disease, or infection. Symptoms may include pain, loss of motor control, and sensory deficits.
The anterior divisions of the lumbar nerves, sacral nerves, and coccygeal nerve form the lumbosacral plexus, the first lumbar nerve being frequently joined by a branch from the twelfth thoracic. For descriptive purposes this plexus is usually divided into three parts:
The lumbar plexus is a web of nerves (a nerve plexus) in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the divisions of the first four lumbar nerves (L1-L4) and from contributions of the subcostal nerve (T12), which is the last thoracic nerve .
This condition most commonly affects people with type 2 diabetes, although sometimes presents in those without diabetes (nondiabetic lumbosacral radiculoplexus neuropathy). [3] The population trends suggest that hyperglycemia likely plays a role but may not be the causative factor. [4]
The lumbosacral trunk is formed by the union of the entire anterior ramus of lumbar nerve L5 and a part of L4 [clarification needed]. [1] [2] [3] L4 first issues its branches to the lumbar plexus, then emerges from the medial border of the psoas muscle [3] to unite with the anterior ramus of L5 just superior to the pelvic brim to form the thick, cord-like trunk which [4] crosses the pelvic ...
Similarly, in the case of lumbosacral radiculopathy, a straight leg raise maneuver or a femoral nerve stretch test may demonstrate radiculopathic symptoms down the leg. [3] Deep tendon reflexes (also known as a stretch reflex) may be diminished or absent in areas innervated by a particular nerve root. [citation needed]