The natural history of sciatica: A prospective radiological study

Cowan, Nigel C.; Bush, Keith; Katz, David; Gishen, P.

doi:10.1016/s0009-9260(05)80025-x

Cited by 37 publications

(8 citation statements)

References 23 publications

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“…31 So if surgery is performed earlier after the diagnosis, prognosis will be better. 32 So this study hypothesizes that in MRI is preferred modality of investigation for chronic low backache due to degenerative spine disease than any other modality. MRI findings usually matched with clinical symptoms of patients of low backache but not always this thing facilitates requirement of clinico-radiological correlation and helps in disease management.…”

Section: Discussionmentioning

confidence: 95%

A prospective study of magnetic resonance imaging findings in patients of chronic low back pain: a clinico-radiological correlation

Singh¹,

Mehra²,

Gaur³

2016

Int J Res Med Sci

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Section: Discussionmentioning

confidence: 95%

A prospective study of magnetic resonance imaging findings in patients of chronic low back pain: a clinico-radiological correlation

Singh¹,

Mehra²,

Gaur³

2016

Int J Res Med Sci

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“…All of them reported marked diminution of symptoms many days after the first injection (local anesthetic) perhaps due to placebo effect. Although the lumbar facet joint as a source of low-back pain becomes more confusing the more clinical studies that are reported, 5,9,10,14,17,19,25,33,36,38,39 the facet joint may be responsible for at least some degree of low-back pain with pseudoradicular and radicular radiation. 2,3,7,8,11,12,15,17,21,24,[26][27][28]30,37,43 Experimentally, a marked reduction of the nerve activity occurs in facet tissue injected with local anesthetic and corticosteroid agents.…”

Section: Neurosurg Focus / Volume 13 / August 2002mentioning

confidence: 99%

Indications for and benefits of lumbar facet joint block: analysis of 230 consecutive patients

Bani

Spetzger²,

Gilsbach³

2002

FOC

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Object The authors evaluated the effectiveness of using a facet joint block with local anesthetic agents and or steroid medication for the treatment of low-back pain in a medium-sized series of patients. Methods Over a period of 4 years, the authors performed 715 facet joint injections in 230 patients with variable-length histories of low-back pain. The main parameter for the success or failure of this treatment was the relief of the pain. For the first injection—mainly a diagnostic procedure—the authors used a local anesthetic (1 ml bupivacaine 1%). In cases of good response, betamethasone was injected in a second session to achieve a longer-lasting effect. Long-lasting relief of the low-back pain and/or leg pain was reported by 43 patients (18.7%) during a mean follow-up period of 10 months. Thirty-five patients (15.2%) noticed a general improvement in their pain. Twenty-seven patients (11.7%) reported relief of low-back pain but not leg pain. Nine patients (3.9%) suffered no back pain but still leg pain. One hundred sixteen patients (50.4%), however, experienced no improvement of pain at all. In two cases the procedure had to be interrupted because of severe pain. There were no cases of infection or hematoma. Conclusions Lumbar facet joint block is a minimally invasive procedure to differentiate between facet joint pain and other causes of lower-back pain. The procedure seems to be useful for distinguishing between facet joint pain from postoperative pain due to inappropriate neural decompression after lumbar surgery. It can be also recommended as a possible midterm intervention for chronic low-back pain.

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“…It is generally recommended to perform surgical treatment in lumbar disc herniation (LDH) for patients who suffer from cauda equina syndrome or intractable radicular pain, with or without neurological sensory/motor deficit 21) . However, in numerous non-fatal cases, conservative treatment such as a nerve block could be effective 9 20 24) . In patients with LDH, a nerve block is generally performed before considering surgery for radicular pain as well 3 10 13 20) .…”

Section: Introductionmentioning

confidence: 99%

Surgery versus Nerve Blocks for Lumbar Disc Herniation : Quantitative Analysis of Radiological Factors as a Predictor for Successful Outcomes

Kim

Hur

Lee

et al. 2016

J Korean Neurosurg Soc

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ObjectiveTo assess the clinical and radiological factors as predictors for successful outcomes in lumbar disc herniation (LDH) treatment.MethodsTwo groups of patients with single level LDH (L4–5) requiring treatment were retrospectively studied. The surgery group (SG) included 34 patients, and 30 patients who initially refused the surgery were included in the nerve blocks group (NG). A visual analogue scale (VAS) for leg and back pain and motor deficit were initially evaluated before procedures, and repeated at 1, 6, and 12 months. Radiological factors including the disc herniation length, disc herniation area, canal length-occupying ratio, and canal area-occupying ratio were measured and compared. Predicting factors of successful outcomes were determined with multivariate logistic regression analysis after the optimal cut off values were established with a receiver operating characteristic curve.ResultsThere was no significant demographic difference between two groups. A multivariate logistic regression analysis with radiological and clinical (12 months follow-up) data revealed that the high disc herniation length with cutoff value 6.31 mm [odds ratio (OR) 2.35; confidence interval (CI) 1.21–3.98] was a predictor of successful outcomes of leg pain relief in the SG. The low disc herniation length with cutoff value 6.23 mm (OR 0.05; CI 0.003–0.89) and high baseline VAS leg (OR 12.63; CI 1.64–97.45) were identified as predictors of successful outcomes of leg pain relief in the NG.ConclusionThe patients with the disc herniation length larger than 6.31 mm showed successful outcomes with surgery whereas the patients with the disc herniation length less than 6.23 mm showed successful outcomes with nerve block. These results could be considered as a radiological criteria in choosing optimal treatment options for LDH.

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The natural history of sciatica: A prospective radiological study

Cited by 37 publications

References 23 publications

A prospective study of magnetic resonance imaging findings in patients of chronic low back pain: a clinico-radiological correlation

A prospective study of magnetic resonance imaging findings in patients of chronic low back pain: a clinico-radiological correlation

Indications for and benefits of lumbar facet joint block: analysis of 230 consecutive patients

Surgery versus Nerve Blocks for Lumbar Disc Herniation : Quantitative Analysis of Radiological Factors as a Predictor for Successful Outcomes

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