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European Spine Journal

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01-09-2019 | Neuropathic Pain | Original Article

Decreased tibial nerve movement in patients with failed back surgery syndrome and persistent leg pain

Authors: G. Shum, S. Cinnamond, M. Hutton, D. Chan, R. Chauhan, S. Bloxham, S. Choy, R. Cheung, S. Eldabe, A. Clarke

Published in: European Spine Journal | Issue 9/2019

Abstract

Purpose

To measure and compare the total and normalised tibial nerve movements during forward bending in patients with and without failed back surgery syndrome (FBSS) and persistent leg pain following anatomically successful lumbar decompression surgery and demonstrated no psychological stress. Nerve pathomechanics may contribute to FBSS with persistent leg pain following anatomically successful lumbar decompression surgery.

Methods

Tibial nerve movement during forward bending was measured in two groups of patients following anatomically successful lumbar decompression surgery. FBSS group (N = 37) consisted of patients with persistent leg pain following lumbar surgery, and non-FBSS (N = 37) were patients with no remaining leg pain following lumbar surgery. Total and normalised tibial nerve movement at the popliteal fossa was measured by a previously validated ultrasound imaging technique and compared between the two groups, and also between the painful and non-painful leg within the FBSS group.

Results

Both the mean total and normalised tibial nerve movement were significantly decreased in the FBSS group in both legs when compared to the non-FBSS group (P < 0.05). The total and normalised tibial nerve movements were also more restricted in the painful leg (P < 0.05) when compared to the non-painful side within the FBSS group.

Conclusion

This was the first study to quantify the decreased total and normalised tibial nerve mobility in FBSS patients with persistent leg pain when compared with non-FBSS patients following anatomically successful lumbar decompression surgery. Further research could investigate the efficacy of intervention, such as nerve mobilisation in this particular group of patients with failed back surgery syndrome and limited nerve mobility.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

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Title: Decreased tibial nerve movement in patients with failed back surgery syndrome and persistent leg pain
Authors: G. Shum
S. Cinnamond
M. Hutton
D. Chan
R. Chauhan
S. Bloxham
S. Choy
R. Cheung
S. Eldabe
A. Clarke
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Keywords: Neuropathic Pain
Leg Pain
Leg Pain
Published in: European Spine Journal / Issue 9/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-06056-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Decreased tibial nerve movement in patients with failed back surgery syndrome and persistent leg pain

Abstract

Purpose

Methods

Results

Conclusion

Graphic abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Graphic abstract

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