Haldeman S, Shouka M, Robboy S
Department of Neurology, University of California, Irvine.
Spine (Phila Pa 1976). 1988 Mar;13(3):345-50. doi: 10.1097/00007632-198803000-00021.
One hundred patients with complaints of low-back pain and leg pain, consistent with a diagnosis of sciatica, were evaluated. All patients had complaints for longer than 6 months and had recently undergone electrodiagnostic testing and computed tomography (CT). Correlation was made between symptoms, straight leg raising, clinical neurological deficits, electrodiagnostic and CT findings. The radiation of pain above or below the knee and pain on straight leg raising did not show a high correlation with each other or with neurological deficits or CT findings. Electrodiagnostic studies often defined a radiculopathy in patients with equivocal clinical signs. CT findings did not predict the nature of symptoms or clinical and electrodiagnostic findings. Electrodiagnostic abnormalities showed the greatest ability to predict CT abnormalities. It is concluded that in chronic sciatica patients, no single diagnostic parameter is conclusive and a combination of clinical and laboratory findings is necessary to reach a diagnosis. In addition, many assumptions, valid in patients with acute pain cannot be extrapolated to patients with chronic sciatica.
对100例主诉下腰痛和腿痛、符合坐骨神经痛诊断的患者进行了评估。所有患者的症状持续超过6个月,且近期接受过电诊断测试和计算机断层扫描(CT)。对症状、直腿抬高试验、临床神经功能缺损、电诊断结果和CT检查结果进行了相关性分析。膝上或膝下疼痛的放射情况与直腿抬高试验时的疼痛之间,以及与神经功能缺损或CT检查结果之间均未显示出高度相关性。电诊断研究常常能在临床体征不明确的患者中确定神经根病。CT检查结果无法预测症状的性质或临床及电诊断结果。电诊断异常显示出预测CT异常的最大能力。得出的结论是,在慢性坐骨神经痛患者中,没有单一的诊断参数是决定性的,需要结合临床和实验室检查结果才能做出诊断。此外,许多在急性疼痛患者中有效的假设不能外推到慢性坐骨神经痛患者身上。