Groin Pain Caused by L3 and L4 Radiculopathy

Background: Previous reports have described patients with groin pain induced by lumbar radiculopathy below the L3 spinal level, but this type of groin pain has not been studied in detail. This retrospective clinical study investigated the possibility of groin pain caused by lumbar radiculopathy below the L3 spinal level. Methods: We reviewed the clinical records of 210 consecutive patients who were surgically treated for singlelevel lumbar radiculopathy between June 2005 and September 2012. We examined the spinal level of the affected nerve root, clinical symptoms, and surgical outcomes based on the Japanese Orthopedic Association (JOA) score for lumbar diseases and a visual analog scale (VAS) for leg pain. Results: The 210 patients underwent surgery for single-level lumbar radiculopathy due to L3 radiculopathy (7 patients), L4 radiculopathy (20), L5 radiculopathy (127), or S1 radiculopathy (56). Groin pain was experienced by 8 patients (3 patients with L3 and 5 with L4 radiculopathy). Most of these 8 patients also experienced pain in the anterior thigh (6 patients) or knee (5 patients) regions. The pain experienced by these patients was relieved by surgical decompression of the affected nerve roots. The JOA and VAS scores showed significant improvement postoperatively. The mean postoperative follow-up period was 19.6 months (range, 6–40 months), during which time none of the patients required additional treatment for groin pain. Conclusions: L3 or L4 radiculopathy should be considered during the examination of patients with groin pain and radicular leg pain.