Lumbar Disc Herniation, the Association Between Quantitative Sensorial Test and Magnetic Resonance Imaging Findings

• Published in: Pain medicine (Malden, Mass.) Vol. 19; no. 7; pp. 1373 - 1381
• Main Authors: Erbüyün, Serpil Canan, Ovalı, Gülgün Yılmaz, Özyurt, Beyhan, Yentür, E Alp
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-07-2018
• Subjects: Adolescent; Adult; Aged; Compression; Female; Humans; Intervertebral Disc Displacement - diagnosis; Intervertebral discs; Leg; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Neurologic Examination - methods; NMR; Nuclear magnetic resonance; Pain perception; Patients; Sensory Thresholds - physiology; Spine; Young Adult; Magnetic Resonance Imaging; Pain; Quantitative Sensory Testing; Dischernia
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1093/pm/pnx236

Abstract
Objective
Quantitative sensorial tests (QST) are used for evaluating specific sensorial nerve function. In this study, QST and magnetic resonance imaging (MRI) findings are compared in lumbar disc herniation patients, and the accuracy of QST data was investigated.
Material and Methods
Sixty-four patients between 18 and 70 years of age suffering from radicular pain with positive Lasegue’s test were included in this study. Specific criteria included complaints due to L5 discopathy. MRI findings were classified according to the Pfirmann grading system, and QST was applied to the L5 dermatoma of both symptomatic and nonsymptomatic legs of all patients. Vibration detection threshold, heat detection threshold, cold detection threshold, and heat pain detection threshold values were obtained, and MRI findings were classified according to the Pfirmann grading system.
Results
When we compared the symptomatic and nonsymptomatic legs of participants, there were significant differences by means of all QST parameters (0 = 0.00). In a comparison of the QST and MRI Pfirmann grading systems, there is also a strong parallel statistical correlation between the Pfirmann grade and QST parameters (P < 0.05).
Conclusions
According to the results of our study, QST has an additive effect to MRI for nerve root compression evaluation in the clinical basis, which might enable more sensitive diagnosis and treatment protocol. QST can also be an alternative method for evaluation of nerve root compression in patients who have contraindications for MRI.