Radiculopathy in degenerative lumbar scoliosis: correlation of stenosis with relief from selective nerve root steroid injections
Φόρτωση...
Ημερομηνία
Συγγραφείς
Ploumis, A.
Transfeldt, E. E.
Gilbert, T. J.
Mehbod, A. A.
Pinto, M. R.
Denis, F.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Pain Med
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
OBJECTIVE: The purpose is to define the origin of radiculopathy of patients with degenerative lumbar scoliosis-stenosis and to assess the correlation between percentage of initial radicular leg pain relief with selective nerve root injections and lateral canal dimensions. DESIGN: Retrospective clinical study. SETTING AND PATIENTS: Thirty-six consecutive patients (average age 72) from Twin Cities Spine Center with degenerative lumbar scoliosis (average major curve 25 degrees ) and radicular symptoms were studied. INTERVENTIONS: Patients underwent 46 selective steroid injections of nerve roots concordant with clinical symptomatology. OUTCOME MEASURES: Radiographic measurements included major and lumbosacral curve Cobb angle. Computerized measurements of magnetic resonance imaging (MRI) included minimum subarticular height and foramen cross-sectional area of the nerve roots that were injected. Initial response from the nerve root injections was also rated. RESULTS: Twenty-five percent of nerve root symptoms were coming from the major curve, 72.2% from the lumbosacral hemicurve and 2.8% from both (P<0.001). The affected nerve roots were more frequently the L4 (34.8%) and L5 (28.3%) nerve roots. A total of 71.7% of radicular symptoms were originating from the concavity of the curve and 28.7% from the convexity (P<0.001). The relief from injections was more than 50% in 75% of the patients at 15 days postinjection. There was no statistical significant correlation (P>0.05) between the lateral canal dimensions and the initial response to injection of anesthetic plus steroid injection. CONCLUSIONS: In degenerative lumbar scoliotic curves, radicular symptoms are attributed mainly to nerve roots exiting from the concavity of the lumbosacral hemicurve. No evidence was found that the rate of initial relief from selective nerve root injections correlates with the degree of stenosis noted in the MRI.
Περιγραφή
Λέξεις-κλειδιά
Adult, Aged, Anti-Inflammatory Agents/administration & dosage/*therapeutic use, Female, Fluoroscopy, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pain Measurement, Radiculopathy/*drug therapy/*etiology/pathology, Retrospective Studies, Scoliosis/*complications/pathology, *Spinal Nerve Roots/radiography, Spinal Stenosis/*drug therapy/*etiology, Steroids/administration & dosage/*therapeutic use, Treatment Outcome
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/21087400
http://onlinelibrary.wiley.com/store/10.1111/j.1526-4637.2010.01000.x/asset/j.1526-4637.2010.01000.x.pdf?v=1&t=h0nyj62k&s=3f9a8e92a7f5f237349648c028b6df5150cc3efc
http://onlinelibrary.wiley.com/store/10.1111/j.1526-4637.2010.01000.x/asset/j.1526-4637.2010.01000.x.pdf?v=1&t=h0nyj62k&s=3f9a8e92a7f5f237349648c028b6df5150cc3efc
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής