Fibrocartilaginous Embolism Presenting as Isolated L2-3 Radiculopathy without Spinal Cord Infarction.

Abstract

Lumbosacral radiculopathy often presents as back pain and lower limb weakness and is frequently encountered in rehabilitation medicine. Fibrocartilaginous embolism (FCE) is an uncommon but significant vascular cause of radiculopathy. It occurs when the disc-derived fibrocartilaginous material enters the spinal vasculature, leading to embolic infarction. We present the case of a 54-year-old female who developed right lower limb weakness and sensory impairment after lifting an adult male. Lumbosacral MRI revealed infarctions involving the L3 vertebral body, right L3 dorsal root ganglion, and paraspinal muscles. CT angiography demonstrated embolic occlusion of the right third lumbar artery, and electromyography confirmed right L2-3 radiculopathy. The patient was conservatively treated with aspirin and physical therapy. Over time, the motor weakness and electromyographic amplitudes in the affected lower limb improved. To our knowledge, this is the first reported case of FCE causing isolated L2-3 radiculopathy without spinal cord infarction.