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Titolo:
Recovery of severe sciatica
Autore:
Balague, F; Nordin, M; Sheikhzadeh, A; Echegoyen, AC; Brisby, H; Hoogewoud, HM; Fredman, P; Skovron, ML;
Indirizzi:
Hop Cantonal, Serv Rheumatol Med Phys & Reeduc, CH-1708 Fribourg, Switzerland Hop Cantonal Fribourg Switzerland CH-1708 CH-1708 Fribourg, Switzerland NYU Med Ctr, Hosp Joint Dis, New York, NY USA NYU Med Ctr New York NY USA YU Med Ctr, Hosp Joint Dis, New York, NY USA Sahlgrens Univ Hosp, Dept Orthopaed, S-41345 Gothenburg, Sweden Sahlgrens Univ Hosp Gothenburg Sweden S-41345 S-41345 Gothenburg, Sweden Sahlgrens Univ Hosp, Dept Neurochem, Molndal, Sweden Sahlgrens Univ Hosp Molndal Sweden osp, Dept Neurochem, Molndal, Sweden Genentech Inc, S San Francisco, CA 94080 USA Genentech Inc S San Francisco CA USA 94080 S San Francisco, CA 94080 USA
Titolo Testata:
SPINE
fascicolo: 23, volume: 24, anno: 1999,
pagine: 2516 - 2524
SICI:
0362-2436(199912)24:23<2516:ROSS>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOW-BACK-PAIN; LUMBAR INTERVERTEBRAL-DISK; INFLAMMATORY DEMYELINATING POLYRADICULONEUROPATHY; NERVE ROOT COMPRESSION; COMPUTED-TOMOGRAPHY; FOLLOW-UP; NEUROLOGICAL DISORDERS; PERIPHERAL-NERVE; NATURAL-HISTORY; HERNIATION;
Keywords:
antibodies; clinical tests; EMG; imaging; outcome study; predictors; sciatica;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
84
Recensione:
Indirizzi per estratti:
Indirizzo: Balague, F Hop Cantonal, Serv Rheumatol Med Phys & Reeduc, CH-1708 Fribourg, Switzerland Hop Cantonal Fribourg Switzerland CH-1708 ibourg, Switzerland
Citazione:
F. Balague et al., "Recovery of severe sciatica", SPINE, 24(23), 1999, pp. 2516-2524

Abstract

Study Design. A prospective study of patients with acute severe sciatica. Objectives. To 1) describe the characteristics of patients with acute severe sciatica and the agreement among different diagnostic tests, 2) describeoverall recovery during 1 year in terms of perceived disability, and pain,and 3) explore acute-phase predictors of failure to recover at 1 year. Summary of Background Data. The development of imaging techniques has beenvery impressive during recent decades. However, different authors have high-lighted the prevalence of abnormal images among asymptomatic subjects. These findings increase the difficulty of interpreting the results from the diagnostic techniques used with each individual patient. Furthermore, other clinical and biopsychosocial variables need to be explored for their associations with recovery or failure to recover. This study aimed to explore those associations. Methods. Consecutive patients admitted to the hospital for conservative management of severe acute sciatica were eligible for inclusion in the study. Patients were evaluated at admission, discharge, and 3, 6, and 12 months. All the visits included a standardized clinical examination and the completion of questionnaires that included items on demographics, pain perceived disability, and quality of life. Imaging and blood samples were collected atthe first visit, and an electromyogram was taken for sciatica lasting at least 3 weeks. Results. The study included 82 consecutive patients (66% men) with a mean age of 43 +/- 10.3 years. The mean intensity of pain, on a visual analog scale of 0 to 100 (VAS) at Visit 1, was 73. The straight leg raising test waspositive in 78% of the patients, with a mean value of 59 degrees +/- 18 degrees. The contralateral straight leg raising test was positive in 20% of the patients. Imaging was positive for disc herniation in 74% and electromyogram was positive in 62% of cases. These two diagnostic tests showed a goodto excellent total agreement (58-87%) with the straight leg raising tests and the presence of radiating pain below the knee. The recovery of clinicalsymptoms and signs was observed mainly within the first 3 months. However,clinical recovery and perceived recovery was not complete in most cases. Conclusions. In most cases, there was good to excellent agreement among the different diagnostic tests. None of the tests was predictive of recovery. The presence of blood antibodies against 3'LM1 (IgM + IgG) and GD1a (IgM) was significantly associated (P < 0.023) with neurologic symptoms and signs. However, the meaning of these antibodies remains unclear. Only a minorityof the patients (29%) had fully recovered after 12 months. Within the 1-year follow-up, one third of the patients had surgery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 11:34:48