Prognostic value of early computed tomography in radiculopathy due to lumbar intervertebral disk herniation. A prospective study - 01/01/03
Catherine Beauvais a * 1 , Marc Wybier b 1 , Pascal Chazerain c 1 , Marc Harboun d , Frédéric Lioté e 1 , Jacques Roucoulès f 1 , Anne Claude Koeger g 1 , Laurence Bellaiche b 1 , Philippe Orcel e 1 , Thomas Bardin e 1 , Jean-Marc Ziza c 1 , Jean Denis Laredo b 1 *Corresponding authors.
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Résumé |
Objective. - To prospectively evaluate the relationship between the early computerized tomography (CT) features of disk herniation and the clinical outcome in patients with recent-onset sciatic or femoral neuralgia treated conservatively. Early CT is often used, despite the absence of data on usefulness for predicting outcomes.
Methods. - Of 78 patients with sciatica or femoral neuralgia of less than 1 month's duration, presumably due to a disk herniation, 75 were found by CT to have a disk herniation at the expected level. All patients were treated conservatively. The 60 patients who were reassessed clinically after 3 months were included in the study. Based on the results of the clinical assessment, the patients were classified as having a good outcome (complete or partial recovery) or a poor outcome. CT findings were compared in these two groups.
Results. - None of the features of disk herniation studied on the CT scans were significantly correlated with the clinical outcome. A larger herniation or presence of a free fragment was more common in the good outcome group, but the differences were not statistically significant (P= 0.07).
Conclusion. - In this study, early CT scan did not predict the clinical outcome of patients with nerve root pain from lumbar disk herniation. None of the CT criteria was associated with a poor clinical outcome. Early CT scan has no prognostic value in this setting.
Mots clés : Sciatica ; Spine ; Intervertebral disk ; Spine ; Computed tomography.
Plan
Vol 70 - N° 2
P. 134-139 - avril 2003 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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