Research on the occurrence of nerve root symptoms in hernia of the L5-S1 nucleus pulposus

Przemysław Minta, Zbigniew Śliwiński, Andrzej Permoda, Natalia Szapowałow

Przemysław Minta, Zbigniew Śliwiński, Andrzej Permoda, Natalia Szapowałow – Research on the occurrence of nerve root symptoms in hernia of the L5-S1 nucleus pulposus. Fizjoterapia Polska 2003; 3(3); 256-260

Abstract

Background. The number of patients pathological changes in the lumbo-sacral spine is rising rapidly. It is still a common practice to implement treatment in lumbo-sacral pain syndrome based on the results of nerve root tests. The goal of the present study was to identify codependencies between the occurrence of certain positive nerve root tests on sex, age, and time since onset. Material and methods. Four nerve root tests were performed on 400 patients treated at the authors’ health resort for pain due to hernia of the L5-S1 nucleus pulposus, confirmed by CT or MRI. Results. The co-occurrence of L5-S1 hernia and various other pathological changes in the spine was found in 88.5% of the subjects. These included pathologies of the intervertebral disks on the higher levels, degeneration of bony elements and intervertebral joints and yellow ligaments. The frequency of co-occurrence of hernia with degenerative changes rose with age, regardless of sex. Positive nerve-root tests were found in 51.5% of the subjects. Inactive nerve root syndromes affected nearly half the subjects, while the frequency of occurrence rose with age and time since onset. Conclusions. In our patient population no simple dependence was found between the results of objective imaging tests and the occurrence of nerve root symptoms. The frequency of occurrence of positive nerve root tests decreased with the increasing age of the subjects and the time since onset. The Bragard and Hoover nerve root tests do not guarantee a sufficient degree of diagnostic confidence.

Key words:
hernia of the nucleus pulposus, nerve root tests, Lasegue test, Kernig test, Bragard test, Hoover test
Invalid download ID. Pobierz bezpłatnie artykuł w j. angielskim