MALFORMATION OF LUMBAR SPINAL ROOTS AND SHEATHS IN THE CAUSATION OF LOW BACKACHE AND SCIATICA

It is well established that lumbar root compression, resulting in pain in the lumbar region and sciatica, may be caused by a variety of lesions, such as herniation of intervertebral discs, hypertrophy of the ligamentum flavum, osteochondrosis and spinal neurinomata. It is also well known that identical symptoms may develop in cases of root adhesion and radiculitis. Within recent years four cases of malformation of lumbar roots and sheaths have come under the observation of the authors, displaying clinical changes which are grossly indistinguishable from those found in the conditions mentioned above. In reviewing the recent literature we have been unable to find such malformations described in conjunction with the problem of low back pain and sciatica. CASE REPORTS Case 1-Woman aged thirty-one years. At the age of nineteen she had for a period of about three months suffered from a dull pain in the back of the right thigh and calf. This was relieved by manipulation. Eighteen months before entering hospital she began to complain of pain in the lumbar region. Some months later the pain began to pass to the back of the right thigh, and eventually also to the calf and the great toe. She had noticed a transitory tingling numbness i