P-3-05-05
SIGNS AND SYMPTOMS IN LUMBAR DISC HERNIATION, 5-YEAR RETROSPECTIVE STUDY
Patcharawimol Srisa-an (Mahidol University, Bangkok, Thailand)
Monratta Pitakjaroen (Mahidol Umvcrsity, Bangkok, Thailand)
The purpose of this study is to determine correlation of clinical signs and symptoms in herniated nucleus pulposus (HNP) patients between conservative and surgical groups. We compared 103 HNP patients (mean age 35 years, male 40, female 63) in conservative group and 37 HNP patients (mean age 35, male 10, female 27) in surgical group. The diagnosis was established by clinical evaluation. Some patients in conservative group and all in surgical group were confirmed by myelogram, CT or MRI.
History of low back pain and referred pain to lower extremity was more common in conservative group but Straight Leg Raising Test in both groups had no statistical difference. Complaint of lower extremity numbness was more common in surgical group whereas decreased pin prick sensation was found more in conservative group. Interestingly, weakness of flexor hallucis longus muscle and decreased deep tendon reflex at ankle joint were more common in surgical group.
This study suggests that complete physical examination, especially neuromuscular system, is importance for management planning although there are many sophisticated investigations.
P-3-05-06
RELIABILITY OF COMPUTERIZED MOTION ANALYSIS AS A DETECTOR OF SIGNIFICANT LUMBAR DISC PATHOLOGY
Itoi Megumi*, Hirasawa Yasusuke*, Zucherman James F.** Hsu Ken**, Gould Erica** (*Kyoto Prefectural University of Medicine, Japan. **St. Mary's Spine Center, San Francisco, U.S.A.)
The Spinoscope is a device which has been shown to measure real time three dimensional inter segmental mobility (ISM) of the lumbar spine. It has been used as a functional evaluation of patients with low back pain. With this device we analyzed three dimensional motion of lumbar spine and studied the clinical correlation with discogram and discogram-CT(CTD).
[Method] Statistical analysis of 42 Spinoscope cases (mean 40.1 years) which had discogram & CTD was performed. All cases had chronic low back and or leg pain and showed abnormal findings in discogram & CTD. We measured (1) flexion and (2) lateral bending with unloaded and loaded and evaluated each ISM using mean and standard deviations (SD) of normal data (40 cases).
[Result] The mean and SD of each ISM at 60 degrees flexion was significantly restricted compared to that of normal cases from L2 to L5 (P<0.005). In 90.5% of the subjects ISM was restricted on pathological levels including adjacent levels where discogram and CTD showed abnormal findings. However we could not find the correlation of specific anatomic levels between Spinoscope and discogram & CTD because ISM had a tendency to be restricted in broad area including adjacent abnormal lesions of discogram & CTD.
[Conclusion] This study shows that Spinoscopy ISM measurement is abnormal in cases of painful degenerative disc disease. Since the sensitivity is high, it seems to be a useful non-invasive test to detect disabling discogenic disease.
