Clinical features as predictors of histologically confirmed inflammation in patients with lumbar disc herniation with associated radiculopathy

Autor:	Omar Kaddour, Patrick Page, Michael Gonzales, Andrew J. Hahne, Jon J. Ford
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	medicine.medical_specialty lcsh:Diseases of the musculoskeletal system Visual analogue scale Physical examination Scoliosis Lumbar vertebrae Cohort Studies 03 medical and health sciences 0302 clinical medicine Lumbar Rheumatology Internal medicine medicine Back pain Humans Orthopedics and Sports Medicine 030212 general & internal medicine Radiculopathy Clinical predictors Inflammation Lumbar Vertebrae medicine.diagnostic_test business.industry Intervertebral disc medicine.disease Low back pain medicine.anatomical_structure Lumbar disc herniation medicine.symptom lcsh:RC925-935 business 030217 neurology & neurosurgery Intervertebral Disc Displacement Research Article
Zdroj:	BMC Musculoskeletal Disorders, Vol 21, Iss 1, Pp 1-9 (2020) BMC Musculoskeletal Disorders
ISSN:	1471-2474
DOI:	10.1186/s12891-020-03590-x
Popis:	Background An understanding of the clinical features of inflammation in low back pain with or without leg symptoms may allow targeted evaluations of anti-inflammatory treatment in randomised-controlled-trials and clinical practice. Purpose This study evaluated the diagnostic accuracy of clinical features to predict the presence/absence of histologically confirmed inflammation in herniated disc specimens removed at surgery in patients with lumbar disc herniation and associated radiculopathy (DHR). Study design Cohort Study. Methods Disc material from patients with DHR undergoing lumbar discectomy was sampled and underwent histological/immunohistochemistry analyses. Control discs were sampled from patients undergoing surgical correction for scoliosis. Baseline assessment comprising sociodemographic factors, subjective examination, physical examination and psychosocial screening was conducted and a range of potential clinical predictors of inflammation developed based on the existing literature. Multi-variate analysis was undertaken to determine diagnostic accuracy. Results Forty patients with DHR and three control patients were recruited. None of the control discs had evidence of inflammation compared to 28% of patients with DHR. Predictors of the presence of histologically confirmed inflammation included back pain Conclusion In a sample of patients with lumbar DHR a combination of clinical features predicted the presence or absence of histologically confirmed inflammation. Clinical relevance These clinical features may enable targeted anti-inflammatory treatment in future RCTs and in clinical practice.
Databáze:	OpenAIRE
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