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
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Nerve root tests results for diagnosis and prognosis of the pain syndromes in the lumbar spine area treated under spa conditions

Przemysław Minta, Wiesław Tomaszewski, Monika Sobolak

Przemysław Minta, Wiesław Tomaszewski, Monika Sobolak – Nerve root tests results for diagnosis and prognosis of the pain syndromes in the lumbar spine area treated under spa conditions. Fizjoterapia Polska 2012; 12(1); 21-27

Abstract
Disorders associated with low back pain (lbp) are the result of not only affliction of nerve roots, but also nocireceptive innervated structures of the ligaments and joint capsules. The objective of this study was to determine the prevalence of selected nerve root tests in people selected by the Social Insurance Board (SIB) and the National Health Fund (NHF) for spa treatment due to lbp, and their usefulness for diagnosis and prognosis.The study involved a group of 400 people (200 people recommended by SIB and 200 by the NHF). In questionnaires, beside the basic personal characteristics, the following were taken into consideration: disease duration, pain location and radiation, results of imaging tests, employment status and type of work performed. The questionnaires also carried results of some nerve roots tests carried out. Positive nerve root tests occurred more frequently in people recommended by the SIB for prevention of disability pension award, and their frequency increased with duration of illness and PIT taxable allowance period. SIB patients were recommended for treatment as a result of a disease that was at a more advanced stage than patients from NHF. Analysis of obtained data showed that nerve root tests, in both groups were present in only a quarter of the tested patients, hence this points to their limited diagnostic and prognostic value.
Key words:
Low Back Pain, nerve root tests, spa treatment, prevention of disability pension award
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