Lumbosacral Plexopathy: A Single‐Center Review of Etiology, Clinical Presentation, Electrodiagnostic Findings, and Long‐Term Outcomes
Bradley Ong, Jad El Ahdab, Nicolas Thompson, Yuebing Li, Nirmal AndrapalliyalABSTRACT
Introduction/Aims
Lumbosacral plexopathy (LSP) results from a spectrum of etiologies and can cause substantial functional impairment. Limited data exist on the relative distribution of etiologies and outcomes across broad tertiary‐care cohorts spanning multiple causes of LSP. This study aimed to describe the etiologic distribution and characterize the clinical, electrodiagnostic (EDx), and outcome features of LSP.
Methods
We retrospectively reviewed records of patients diagnosed with LSP at our center from January 2000 to September 2024. Definite LSP was defined by a clinical and electrodiagnostic pattern localizing predominantly to the lumbosacral plexus, with supportive sensory and/or imaging findings. Probable LSP met similar clinical and EDx criteria but lacked sufficient sensory or imaging confirmation.
Results
Of 1139 screened records, 124 patients met criteria for LSP (38 definite [30.6%], 86 probable [69.4%]). Median age was 64 years (IQR 54–72), and 59 (47.6%) were female. Symptom onset was acute in 47 (37.9%), subacute in 9 (7.3%), and chronic in 68 (54.8%). Sensorimotor symptoms predominated (71.0%). Leading etiologies included diabetic lumbosacral radiculoplexus neuropathy (34.7%), perioperative injury (25.8%), idiopathic LSP (14.5%), radiation‐induced plexopathy (12.1%), and autoimmune LSP (6.5%). Among 85 patients with follow‐up, 35 (41.2%) achieved full or near‐complete recovery.
Discussion
These findings are consistent with prior descriptions of LSP and radiculoplexus neuropathy and emphasize the heterogeneity of etiologies seen in tertiary care. Recovery was often incomplete, supporting the need for careful diagnostic evaluation and realistic counseling regarding outcome.