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ABSTRACT

This study investigates the relevance of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of root compressions of bony or calcified origin, considering the challenges imposed by the multifactorial etiology of sciatica. The research also reviews advances in understanding the discogenic and non-discogenic causes of the condition, in addition to discussing the limitations of the clinical evaluation of dermatomes, often marked by overlaps and anatomical variability. The analysis of a clinical case involving a 59-year-old patient with left-sided lumbosciatic pain allowed a precise correlation between clinical and radiological findings, highlighting the importance of an integrated diagnostic approach. Computed tomography revealed the presence of a calcified juxtafacet cyst and marginal osteophytes, both directly contributing to root compression. In contrast, MRI was limited in fully elucidating the etiology. Surgical treatment, performed via transforaminal endoscopic approach, resulted in complete symptom relief, significant functional improvement, and early return to daily activities. The findings of this study reinforce the complementary role of imaging techniques in the diagnosis of sciatica and suggest a more careful evaluation of dermatomes in the clinical setting. The adoption of multimodal approaches contributes to greater diagnostic accuracy and therapeutic efficacy, promoting better clinical outcomes for patients affected by radicular syndromes.

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