Neuromuscular morphometric characteristics in low back pain with unilateral radiculopathy caused by disc herniation: An ultrasound imaging evaluation

Abstract

Background:Little is known about the neuromuscular morphometric characteristics in patients with sciatica.Objective: To evaluate the possible changes of nerve and muscle structures in patients with low back pain with unilateral radiculopathy due to lumbar disc herniation by ultrasound imaging. Design:A case-control observational study.Methods: Forty individuals were divided into case (n=20; low back pain with unilateral radiculopathy due to disc herniation), and healthy control groups (n=20). The thickness of lumbar multifidus at L5 level, and of lower limb muscles (i.e., biceps femoris, medial gastrocnemius, and soleus) was measured during both rest and full contraction to calculate the rest/contraction ratio of these muscles. Additionally, the sciatic nerve cross-sectional area and the echogenicity of the nerve and muscles were measured based on ultrasound imaging.The association between severity of low back pain radiculopathy (i.e., pain and patients' perceived disability) and rest/contraction ratio was assessed.Results: Patients with sciatica showed sciatic nerve enlargement, and different contraction ratios for multifidus (at L5) / ankle plantar flexors compared to the controls. The rest/contraction ratio for biceps femoris was similar between the two groups. Conclusion:According to these findings, ultrasound imaging can be considered a useful tool to detect changes in the sciatic nerve and muscles due to disc herniation. Furthermore, regarding the observation of significant changes in muscle rest/contraction ratio in the multifidus and gastrosoleus, one might attribute these changes to the nerve root compression.

Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis

“…Ultrasound has been proven to be beneficial for evaluating nerves in humans (18)(19)(20)(21). The main pathological feature that has been demonstrated by MRI or ultrasonography is nerve enlargement (19,22), and several studies in human patients with sciatica have shown that the sciatic nerve is enlarged on the side of the sciatica (23,24). In dogs, diagnostic ultrasound has been used to locate nerves to perform nerve blocks (25,26).…”

Lumbalgia en pediatría: hallazgos por resonancia magnética

“…Referente a la correlación encontrada entre la discopatía y la radiculopatía que se presentó en al menos el 98% de los casos, cabe señalar que es una incidencia más alta que lo que se ha mostrado en otros estudios, donde dicha correlación se reporta alrededor del 80%. Al parecer dicha correlación se asocia directamente con el mecanismo de deformidad de las discopatías y el efecto que estas generan directamente en las raíces nerviosas derivando en la radiculopatía 12,13 .…”

Neuromuscular ultrasound changes in unilateral symptomatic subacute lumbosacral radiculopathy: A prospective simple blinded cohort study

“…Patients were lying in either a comfortable supine or prone position, depending on the region of interest. NMU assessment of the patients followed a pre‐specified protocol with measurements performed at predetermined anatomical landmarks based on previously reported studies and existing literature 13–17 . The anatomical landmarks for NMU evaluations are depicted in Supplemental Figure 1.…”

“…NMU assessment of the patients followed a pre-specified protocol with measurements performed at predetermined anatomical landmarks based on previously reported studies and existing literature. [13][14][15][16][17] The anatomical landmarks for NMU evaluations are depicted in Supplemental Figure 1. The following parameters for each patient were recorded on both sides: CSA of the sciatic nerve and femoral nerves, fasciculation detection, and CSA measurements of prespecified muscles (see Supplemental Figure 1).…”