Skip to main content
main-content

22.03.2017 | Original Article | Ausgabe 10/2017

European Spine Journal 10/2017

Clinical and radiological factors related to the presence of motor deficit in lumbar disc prolapse: a prospective analysis of 70 consecutive cases with neurological deficit

Zeitschrift:
European Spine Journal > Ausgabe 10/2017
Autoren:
Vibhu Krishnan, Shanmuganathan Rajasekaran, Siddharth N. Aiyer, Rishi Kanna, Ajoy Prasad Shetty

Abstract

Purpose

To analyse the clinic-radiological factors associated with neurological deficit following lumbar disc herniation.

Methods

A prospective, cross-sectional study was performed in 140 cases of micro-discectomy following lumbar disc herniation. Group 1 included 70 consecutive patients with motor deficit and group 2 (controls) included 70 patients with intact neurology. Motor deficit was defined as the occurrence of motor power ≤3/5 in L2–S1 myotomes. Multiple clinical and radiological parameters were studied between the two groups.

Results

Patients with diabetes (p 0.004), acute onset of symptoms (p 0.036), L3–4 discs (p 0.001), sequestrated discs (p 0.004), superiorly migrated discs (p 0.012) and central discs (p 0.004), greater antero-posterior disc dimension (p 0.023), primary canal stenosis (p 0.0001); and greater canal compromise (p 0.002) had a significant correlation with the development of neurological deficit. The presence of four or more of these risk factors showed a higher chance of the presence of motor deficit (sensitivity of 74%, specificity of 77%). Age, sex, previous precipitating events, severity of pain, smoking, and number of herniations levels did not affect the occurrence of deficit (p > 0.05 for all). Patients with or without bladder symptoms were similar with respect to all clinico-radiological parameters. However, the time delay since the occurrence of deficit was significantly shorter in patients with bladder involvement (p 0.001).

Conclusion

Patients with diabetes, acute presentation, central, sequestrated and superiorly migrated discs, high lumbar disc prolapse, and greater spinal canal compromise are predisposed to the presence of motor deficit.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 10/2017

European Spine Journal 10/2017 Zur Ausgabe
  1. Sie können e.Med Orthopädie & Unfallchirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise