A diagnostic study in patients with sciatica establishing the importance of localization of worsening of pain during coughing, sneezing and straining to assess nerve root compression on MRI.

Verwoerd, AJH; Mens, J; El Barzouhi, A; Peul, WC; Koes, BW; Verhagen, AP

A diagnostic study in patients with sciatica establishing the importance of localization of worsening of pain during coughing, sneezing and straining to assess nerve root compression on MRI.

Verwoerd, AJH Mens, J El Barzouhi, A Peul, WC Koes, BW Verhagen, AP

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Publisher:: SPRINGER
Publication Type:: Journal Article
Citation:: Eur Spine J, 2016, 25, (5), pp. 1389-1392
Issue Date:: 2016-05

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Field	Value	Language
dc.contributor.author	Verwoerd, AJH
dc.contributor.author	Mens, J
dc.contributor.author	El Barzouhi, A
dc.contributor.author	Peul, WC
dc.contributor.author	Koes, BW
dc.contributor.author	Verhagen, AP
dc.date.accessioned	2022-07-18T04:30:34Z
dc.date.available	2016-01-15
dc.date.available	2022-07-18T04:30:34Z
dc.date.issued	2016-05
dc.identifier.citation	Eur Spine J, 2016, 25, (5), pp. 1389-1392
dc.identifier.issn	0940-6719
dc.identifier.issn	1432-0932
dc.identifier.uri	http://hdl.handle.net/10453/158995
dc.description.abstract	PURPOSE: To test whether the localization of worsening of pain during coughing, sneezing and straining matters in the assessment of lumbosacral nerve root compression or disc herniation on MRI. METHODS: Recently the diagnostic accuracy of history items to assess disc herniation or nerve root compression on magnetic resonance imaging (MRI) was investigated. A total of 395 adult patients with severe sciatica of 6-12 weeks duration were included in this study. The question regarding the influence of coughing, sneezing and straining on the intensity of pain could be answered on a 4 point scale: no worsening of pain, worsening of back pain, worsening of leg pain, worsening of back and leg pain. Diagnostic odds ratio's (DORs) were calculated for the various dichotomization options. RESULTS: The DOR changed into significant values when the answer option was more narrowed to worsening of leg pain. The highest DOR was observed for the answer option 'worsening of leg pain' with a DOR of 2.28 (95 % CI 1.28-4.04) for the presence of nerve root compression and a DOR of 2.50 (95 % CI 1.27-4.90) for the presence of a herniated disc on MRI. CONCLUSIONS: Worsening of leg pain during coughing, sneezing or straining has a significant diagnostic value for the presence of nerve root compression and disc herniation on MRI in patients with sciatica. This study also highlights the importance of the formulation of answer options in history taking.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SPRINGER
dc.relation.ispartof	Eur Spine J
dc.relation.isbasedon	10.1007/s00586-016-4393-8
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	0903 Biomedical Engineering, 1103 Clinical Sciences
dc.subject.classification	Orthopedics
dc.subject.mesh	Adult
dc.subject.mesh	Cough
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Magnetic Resonance Imaging
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Radiculopathy
dc.subject.mesh	Sciatica
dc.subject.mesh	Sneezing
dc.subject.mesh	Humans
dc.subject.mesh	Cough
dc.subject.mesh	Sciatica
dc.subject.mesh	Radiculopathy
dc.subject.mesh	Sneezing
dc.subject.mesh	Magnetic Resonance Imaging
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.title	A diagnostic study in patients with sciatica establishing the importance of localization of worsening of pain during coughing, sneezing and straining to assess nerve root compression on MRI.
dc.type	Journal Article
utslib.citation.volume	25
utslib.location.activity	Germany
utslib.for	0903 Biomedical Engineering
utslib.for	1103 Clinical Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Physiotherapy
utslib.copyright.status	open_access	*
dc.date.updated	2022-07-18T04:30:33Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	25
utslib.citation.issue	5

Abstract:

PURPOSE: To test whether the localization of worsening of pain during coughing, sneezing and straining matters in the assessment of lumbosacral nerve root compression or disc herniation on MRI. METHODS: Recently the diagnostic accuracy of history items to assess disc herniation or nerve root compression on magnetic resonance imaging (MRI) was investigated. A total of 395 adult patients with severe sciatica of 6-12 weeks duration were included in this study. The question regarding the influence of coughing, sneezing and straining on the intensity of pain could be answered on a 4 point scale: no worsening of pain, worsening of back pain, worsening of leg pain, worsening of back and leg pain. Diagnostic odds ratio's (DORs) were calculated for the various dichotomization options. RESULTS: The DOR changed into significant values when the answer option was more narrowed to worsening of leg pain. The highest DOR was observed for the answer option 'worsening of leg pain' with a DOR of 2.28 (95 % CI 1.28-4.04) for the presence of nerve root compression and a DOR of 2.50 (95 % CI 1.27-4.90) for the presence of a herniated disc on MRI. CONCLUSIONS: Worsening of leg pain during coughing, sneezing or straining has a significant diagnostic value for the presence of nerve root compression and disc herniation on MRI in patients with sciatica. This study also highlights the importance of the formulation of answer options in history taking.

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http://hdl.handle.net/10453/158995