Korean J Pain.  2019 Jul;32(3):147-159. 10.3344/kjp.2019.32.3.147.

Lumbar foraminal neuropathy: an update on non-surgical management

• Choi YK

• KMID: 2455610
• DOI: http://doi.org/10.3344/kjp.2019.32.3.147

Abstract

Lumbar foraminal pathology causing entrapment of neurovascular contents and radicular symptoms are commonly associated with foraminal stenosis. Foraminal neuropathy can also be derived from inflammation of the neighboring lateral recess or extraforaminal spaces. Conservative and interventional therapies have been used for the treatment of foraminal inflammation, fibrotic adhesion, and pain. This update reviews the anatomy, pathophysiology, clinical presentation, diagnosis, and current treatment options of foraminal neuropathy.

Keyword

Constriction, Pathologic; Decompression; Electric Stimulation; Fibrosis; Foraminotomy; Ganglia, Spinal; Inflammation; Lumbosacral Region; Pain Management; Radiculopathy; Spinal Nerve Roots

MeSH Terms

Constriction, Pathologic
Decompression
Diagnosis
Electric Stimulation
Fibrosis
Foraminotomy
Ganglia, Spinal
Inflammation
Lumbosacral Region
Pain Management
Pathology
Radiculopathy
Spinal Nerve Roots

Figure

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  Fig. 1 Superoposterior view of the foramen. Internal (green), intraforaminal (red), and external (blue) zones.

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  Fig. 2 The lateral view of foramen with ligaments, nerve root (NR), and dorsal root ganglion (DRG).

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  Fig. 3 Epiduroscopic findings of inflammation. (A) Mild inflammation, (B) moderate inflammation with fibrosis, and (C) extensive inflammation with granulation and fibrosis.

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  Fig. 4 Epiduroscopic findings of inflammation fibrosis complex. (A) Epidural space is filled with gelatinous exudates and fibrosis, (B) fibrotic bands and meshes, and (C) membranous fibrosis.

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  Fig. 5 Lateral view of foraminal nerve entrapment. (A) Inflamed swollen nerve in normal foramen and (B) compressed nerve in foraminal stenosis. NR: nerve root, DRG: dorsal root ganglion.

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