Symptomatic and asymptomatic abnormalities in patients with lumbosacral radicular syndrome: Clinical examination compared with MRI

To determine the frequency of symptomatic and asymptomatic herniated discs and root compression in patients with lumbosacral radicular syndrome (LRS) and to correlate clinical localization with MRI findings. Fifty-seven patients with unilateral LRS were included in the study. Using the visual analog...

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Bibliographic Details
Published in:	Clinical neurology and neurosurgery Vol. 108; no. 6; pp. 553 - 557
Main Authors:	van Rijn, Jeroen C., Klemetso, N., Reitsma, J.B., Majoie, C.B.L.M., Hulsmans, F.J., Peul, W.C., Bossuyt, P.M., Heeten, G.J. den, Stam, J.
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier B.V 01-09-2006 Elsevier Science Elsevier Limited
Subjects:	Adult Aged Biological and medical sciences Cohort Studies Herniated disc Humans Intervertebral Disc Displacement - complications Intervertebral Disc Displacement - epidemiology Intervertebral Disc Displacement - pathology Low Back Pain - etiology Low Back Pain - pathology Lumbar Vertebrae Magnetic Resonance Imaging Medical History Taking Medical sciences Middle Aged Neurologic examination Neurology Neurosurgery Pain Measurement Physical Examination Radiculopathy - complications Radiculopathy - epidemiology Radiculopathy - pathology Reproducibility of Results Sacrum Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Syndrome Magnetic resonance imaging Neurologic examination Herniated disc Human Radicular syndrome Nervous system diseases Surgery Asymptomatic Lumbosacral Nuclear magnetic resonance imaging
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Summary:	To determine the frequency of symptomatic and asymptomatic herniated discs and root compression in patients with lumbosacral radicular syndrome (LRS) and to correlate clinical localization with MRI findings. Fifty-seven patients with unilateral LRS were included in the study. Using the visual analogue scale, two physicians independently localized the most likely lumbar level of complaints. These clinical predictions of localizations were correlated with the MRI findings. MRI showed abnormalities on the symptomatic side in 42 of 57 patients (74%). In 30% of the patients, MRI confirmed an abnormality at the exact same level as determined after clinical examination. On the asymptomatic side, MRI showed abnormalities in 19 of 57 patients (33%), 13 (23%) of these patients had asymptomatic root compression. In more than two-thirds of the patients with unilateral LRS there was no exact match between the level predicted by clinical examination and MRI findings. These discrepancies complicate the decision whether or not to operate.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0303-8467 1872-6968
DOI:	10.1016/j.clineuro.2005.10.003