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Nico Sollmann, Dominik Weidlich, Barbara Cervantes, Elisabeth Klupp, Carl Ganter, Hendrik Kooijman, Claus Zimmer, Ernst J. Rummeny, Bernhard Meyer, Thomas Baum, Jan S. Kirschke and Dimitrios C. Karampinos

L ow back pain (LBP) is a very common condition that is known to be among the leading causes of years lived with disability, entailing significant decreases of quality of life. 13 , 19 , 41 , 43 Aside from perceiving pain focally in the lower back, patients can suffer from additional or isolated lumbosacral radicular syndrome (LRS), which is commonly referred to as a radiating pain, perceived in one or more lumbar or sacral dermatomes that may be accompanied by other radicular irritation symptoms in addition to the pain, such as paresthesia or impairment of

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Derk J. Hofstee, Johanna M. M. Gijtenbeek, Peter H. Hoogland, Hans C. van Houwelingen, Alfred Kloet, Freek Lötters and Joseph Th. J. Tans

S ciatica or lumbosacral radicular syndrome is a common disorder frequently seen by general practitioners, neurosurgeons, orthopedic surgeons, and neurologists. 4 The incidence of sciatica is approximately five per 1000 inhabitants per year. 5 The symptoms and signs of sciatica include radicular pain in one leg with low-back pain and muscle weakness, sensory loss, paresthesia, or loss of tendon reflexes. 3 The most common cause of sciatica is a prolapsed disc. Other causes are spinal or lateral recess stenosis and occasionally the presence of tumors or

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Mark P. Arts, Wilco C. Peul, Bart W. Koes, Ralph T. W. M. Thomeer and for the Leiden–The Hague Spine Intervention Prognostic Study (SIPS) Group

patients with lumbar disc herniation are still being debated. For example, the optimal timing of surgery in patients with lumbosacral radicular syndrome, cauda equina syndrome, or patients with a painless drop foot is unclear. Moreover, the daily clinical practice of postoperative care, including mobilization, physiotherapy, and restriction of work and daily activities is controversial and may show a large variation. Because there is a relatively high rate of low-back surgery in the Netherlands, an evaluation of the surgeons' use of clinical guidelines seems

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Pravesh S. Gadjradj, Maurits W. van Tulder, Clemens M. F. Dirven, Wilco C. Peul and B. Sanjay Harhangi

W ith an annual incidence of 5 cases per 1000 persons, the lumbosacral radicular syndrome caused by a lumbar disc herniation (LDH) is a frequently observed problem. 14 The most important symptom is lumbosacral radicular leg pain following a dermatomal pattern from below the knee till the feet and toes. The pain worsens with coughing. Other clinical findings may include unilateral spasm of the paraspinal muscles, gait deformity, limited forward flexion, and sensory deficits such as muscle weakness and reflex changes. 20 , 27 Symptomatic LDH can be

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Matthew C. Cowperthwaite, Wilbert B. van den Hout and K. Michael Webb

persistent radicular pain in the L-4, L-5, or S-1 dermatome (with or without mild neurological deficit), severe disabling leg pain (lumbosacral radicular syndrome) lasting 6–12 weeks, and radiologically (MRI) confirmed disc herniation were considered eligible to enroll in the trial. Cauda equina syndrome or severe paresis, prior complaints of lumbosacral radicular syndrome in the previous 12 months, history of same-level unilateral disc surgery, spinal canal stenosis, and degenerative or lytic spondylolisthesis were all exclusion criteria. Cohort demographics and baseline

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Karishma Parikh, Andre Tomasino, Jared Knopman, John Boockvar and Roger Härtl

654 surgically treated lumbar disc herniations . Neurosurgery 30 : 862 – 866 , 1992 16 Perez-Cruet MJ , Foley KT , Isaacs RE , Rice-Wyllie L , Wellington R , Smith MM , : Microendoscopic lumbar discectomy: technical note . Neurosurgery 51 : 5 Suppl S129 – S136 , 2002 17 Peul WC , Van Houwelingen HC , Van den Hout WB , Brand R , Eekhof JA , Tans JT , : [Early surgery or a wait-and-see policy in lumbosacral radicular syndrome: a randomized study.] . Ned Tijdschr Geneeskd 151 : 2512 – 2523 , 2007 . (Dutch) 18

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Abdelilah el Barzouhi, Annemieke J. H. Verwoerd, Wilco C. Peul, Arianne P. Verhagen, Geert J. Lycklama à Nijeholt, Bas F. Van der Kallen, Bart W. Koes, Carmen L. A. M. Vleggeert-Lankamp and For the Leiden–The Hague Spine Intervention Prognostic Study Group

S ciatica , also called sciatic neuralgia or lumbosacral radicular syndrome, is the most common neurological spine disease. It is usually caused by frequently occurring degenerative disc disease, resulting in compression or irritation of a nerve root by herniating disc material. The estimated annual prevalence rate is reported to be between 2.2% and 34%. 20 Differences in study populations and definitions of sciatic symptoms explain most of the variation of reported prevalence estimates. The natural history of sciatica is favorable, with spontaneous

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Sebastian Siller, Rami Kasem, Thomas-Nikolaus Witt, Joerg-Christian Tonn and Stefan Zausinger

system for cervical foraminal stenosis based on axial T2-weighted images . Korean J Radiol 16 : 1294 – 1302 , 2015 26576119 10.3348/kjr.2015.16.6.1294 10 Kostova V , Koleva M : Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors . J Neurol Sci 192 : 17 – 25 , 2001 11701148 10.1016/S0022-510X(01)00585-8 11 Krarup C : Lower motor neuron involvement examined by quantitative electromyography in amyotrophic lateral sclerosis . Clin Neurophysiol 122 : 414 – 422 , 2011 10.1016/j.clinph.2010