Hanne B Albert1, Eva Hauge, Claus Manniche. 1. The Research Department, Spine Centre of Southern Denmark, Østre Houghvej 55, 5500, Middelfart, Denmark. hanne.birgit.albert@slb.regionsyddanmark.dk
Abstract
AIM: To determine the frequency of different patterns of centralization and their association with outcomes and MRI findings in patients experiencing sciatica. METHODS: A prospective longitudinal cohort study of 176 patients with radicular pain below the knee, who all had an MDT clinical assessment. Based on their pain response, patients were divided into five groups: abolition centralization, reduction centralization, unstable centralization, peripheralization, and "no effect". Patients had an MRI. RESULTS: Overall, 84.8% of patients reported experiencing centralization, 7.3% peripheralized and 7.9% reported "no effect". The median reduction in RMQ scores across all the three centralization groups was 9.5 points at 3 months, and 12.0 points at 12 months. The peripheralization group improved similarly. The 'no effect' group improved significantly lower (p < 0.001), by 3.0 at both time points. Patients who centralized, and peripheralized had a significantly reduction in leg pain, the "no effect" group demonstrated a less favorable outcome (p < 0.02). There was no association between pain responses and the type of disc lesion. CONCLUSION: In patients with sciatica, centralization was common and associated with improvement in activity limitation and leg pain. Centralization was very common in ruptured disc therefore the study does not support the theory, that centralization only occurs if the intra-discal hydrostatic mechanism is functional.
RCT Entities:
AIM: To determine the frequency of different patterns of centralization and their association with outcomes and MRI findings in patients experiencing sciatica. METHODS: A prospective longitudinal cohort study of 176 patients with radicular pain below the knee, who all had an MDT clinical assessment. Based on their pain response, patients were divided into five groups: abolition centralization, reduction centralization, unstable centralization, peripheralization, and "no effect". Patients had an MRI. RESULTS: Overall, 84.8% of patients reported experiencing centralization, 7.3% peripheralized and 7.9% reported "no effect". The median reduction in RMQ scores across all the three centralization groups was 9.5 points at 3 months, and 12.0 points at 12 months. The peripheralization group improved similarly. The 'no effect' group improved significantly lower (p < 0.001), by 3.0 at both time points. Patients who centralized, and peripheralized had a significantly reduction in leg pain, the "no effect" group demonstrated a less favorable outcome (p < 0.02). There was no association between pain responses and the type of disc lesion. CONCLUSION: In patients with sciatica, centralization was common and associated with improvement in activity limitation and leg pain. Centralization was very common in ruptured disc therefore the study does not support the theory, that centralization only occurs if the intra-discal hydrostatic mechanism is functional.
Authors: Sinikka Kilpikoski; Olavi Airaksinen; Markku Kankaanpää; Päivi Leminen; Tapio Videman; Markku Alen Journal: Spine (Phila Pa 1976) Date: 2002-04-15 Impact factor: 3.468
Authors: M Heliövaara; O Impivaara; K Sievers; T Melkas; P Knekt; J Korpi; A Aromaa Journal: J Epidemiol Community Health Date: 1987-09 Impact factor: 3.710
Authors: Mark W Werneke; Dennis L Hart; Linda Resnik; Paul W Stratford; Adrian Reyes Journal: J Orthop Sports Phys Ther Date: 2008-03 Impact factor: 4.751
Authors: Adri T Apeldoorn; Hans van Helvoirt; Raymond W Ostelo; Hanneke Meihuizen; Steven J Kamper; Maurits W van Tulder; Henrica C W de Vet Journal: J Man Manip Ther Date: 2016-05