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European Spine Journal

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Open Access 01-05-2016 | Original Article

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

Authors: Annemieke J. H. Verwoerd, Jan Mens, Abdelilah el Barzouhi, Wilco C. Peul, Bart W. Koes, Arianne P. Verhagen

Published in: European Spine Journal | Issue 5/2016

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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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
Authors: Annemieke J. H. Verwoerd
Jan Mens
Abdelilah el Barzouhi
Wilco C. Peul
Bart W. Koes
Arianne P. Verhagen
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 5/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4393-8

ACC 2024 Congress

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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