Lydia R Frost1, Stephen H M Brown2. 1. Department of Human Health and Nutritional Sciences, University of Guelph, 50 Stone Rd East, Guelph, Ontario N1G2W1, Canada. 2. Department of Human Health and Nutritional Sciences, University of Guelph, 50 Stone Rd East, Guelph, Ontario N1G2W1, Canada. Electronic address: shmbrown@uoguelph.ca.
Abstract
BACKGROUND: Patients suffering from chronic low back pain with associated radiculopathy (LBP-R), or sciatica, experience neuromuscular symptoms in the lower back and leg; however, research to date has focussed solely on the lower back. OBJECTIVES: To expand neuromuscular research of LBP-R patients into the lower limb, using ultrasound imaging. DESIGN: Case control study comparing LBP-R patients to matched healthy controls. METHODS: LBP-R patients with disc bulge or herniation (L3/L4 to L5/S1) resulting in unilateral radiculopathy (n = 17) and healthy matched controls (n = 17) were recruited. High-resolution ultrasound imaging was used to investigate sciatic nerve structure, as well as the quality (relative magnitude of fat/fibrosis infiltration) and contraction (muscle thickening) of associated musculature in the lower back (paraspinals) and lower limb (biceps femoris, gastrocnemius, soleus). RESULTS: LBP-R patients had swollen sciatic nerves (increased cross sectional area), but this was not associated with evidence of reduced lower limb muscle quality. As compared to controls, LBP-R patients demonstrated less soleus muscle thickening during submaximal contraction; however, there were no impairments in the hamstring or lower back musculature. CONCLUSIONS: Ultrasound imaging was an effective method to detect sciatic nerve swelling in mild to moderately affected LBP-R patients. Nerve swelling was not associated with poorer muscle quality, nor consistently impaired muscle contraction.
BACKGROUND:Patients suffering from chronic low back pain with associated radiculopathy (LBP-R), or sciatica, experience neuromuscular symptoms in the lower back and leg; however, research to date has focussed solely on the lower back. OBJECTIVES: To expand neuromuscular research of LBP-R patients into the lower limb, using ultrasound imaging. DESIGN: Case control study comparing LBP-R patients to matched healthy controls. METHODS:LBP-R patients with disc bulge or herniation (L3/L4 to L5/S1) resulting in unilateral radiculopathy (n = 17) and healthy matched controls (n = 17) were recruited. High-resolution ultrasound imaging was used to investigate sciatic nerve structure, as well as the quality (relative magnitude of fat/fibrosis infiltration) and contraction (muscle thickening) of associated musculature in the lower back (paraspinals) and lower limb (biceps femoris, gastrocnemius, soleus). RESULTS:LBP-R patients had swollen sciatic nerves (increased cross sectional area), but this was not associated with evidence of reduced lower limb muscle quality. As compared to controls, LBP-R patients demonstrated less soleus muscle thickening during submaximal contraction; however, there were no impairments in the hamstring or lower back musculature. CONCLUSIONS: Ultrasound imaging was an effective method to detect sciatic nerve swelling in mild to moderately affected LBP-R patients. Nerve swelling was not associated with poorer muscle quality, nor consistently impaired muscle contraction.
Authors: Jeffrey R Cooley; Bruce F Walker; Emad M Ardakani; Per Kjaer; Tue S Jensen; Jeffrey J Hebert Journal: BMC Musculoskelet Disord Date: 2018-09-27 Impact factor: 2.362