| Lumbar disc herniation is a kind of disease which leads to low back pain,sciatica,paresthesia,muscle weakness,and even dysfunctions of excretion.It is generally considered to be caused by the compression and irritation of the nerve roots which were the result of degeneration of intervertebral disk and protrusion of nucleus pulposus.It makes differences in clinical work that how to assess the functional status of the roots accurately and choose appropriate operative time or management.However,a convenient way is still needed for doctors.As the nerve roots locate deeply inside,it is difficult to detect it directly.Nevertheless,sciatic nerve might response to the compression of nerve roots in many ways—owing to the fact that sciatic nerve is compose of roots L4-S2.Meanwhile,it is possible for us to measure peripheral nerves with the help of high frequency medical ultrasound imaging technique.In this study,we found that compression of a single nerve root could lead to edema and thickening of sciatic nerve.Additionally,the degrees of thickening were significantly correlated with the pain and functional scores.Finally,we further found that the recovery of sciatic nerve after surgery was correlated to the improvement rate of clinical symptoms.Part?Changes of sciatic nerve in patients with lumbar disc herniation and single nerve root compressionBackground.The main clinical symptom of LDH is sciatica,which is caused by the entrapment of nerve roots,and over 90%patients can be plagued by it.Apparently,the key is to assess the functional status of nerve roots accurately.However,it is difficult to detect the nerve roots directly in clinical work.In this study,we measured sciatic nerve in patients with LDH with the help of high frequency ultrasound imaging technique.Objective.To analyze the relationship between sciatic nerve and nerve roots with the help of ultrasound imaging.Methods.The general data,sonographic images and other imaging materials of patients with LDH were collected retrospectively in Xijing Hospital of the Air Force Military Medical University from October 1,2016 to January 1,2017.The diameter and cross-section area of the sciatic nerve were compared between the affected side and the unaffected side,and they were compared between different types of lumbar herniation on MRI.Results.For LDH patients compressed of a single nerve root,the diameter of sciatic nerve at the affected side was 5.21±1.07 mm,which was significantly thicker than that of the unaffected side(4.61±0.72 mm,p=0.000,t=16.842).The cross-section area of sciatic nerve at the affected side was 52.87±10.04 mm~2,which was significantly greater than that at the unaffected side(46.68±7.24 mm~2,p=0.000,t=17.534).Conclusion.Compression of a single nerve root could lead to edema and thickening of sciatic nerve.Part?Correlation between the diameter/cross-section area of sciatic nerve and clinical symptoms in patients with lumbar disc herniationBackground.Patients with LDH may suffer from low back pain,sciatica,paresthesia,muscle weakness,and even dysfunctions of excretion.Generally speaking,the various symptoms are corresponding with different functional status of nerve,which need for different kinds of treatments.It is still unclear that whether changes in sciatic nerve correlates with clinical symptoms in patients with lumbar disc herniation.Objective.To analyze the relationship between the degree of thickening in sciatic nerve and the severity of symptoms in patients with LDH.Methods.The general data,sonographic images,Visual Analogue Score(including pain in back and leg),Japanese Orthopaedic Association Scores-lumbar,the Oswestry Disability Index and other imaging materials of LDH patients were collected retrospectively in Xijing Hospital of the Air Force Military Medical University from January 1,2017 to December 31,2017.The correlation between the degree of thickening in sciatic nerve and the scores of pain and nerve function were analyzed.Results.For patients with LDH,the R-DIA was correlated with the scores of VAS-leg(p=0.001,r=0.689),ODI(p=0.001,r=0.702)and JOA(p=0.001,r=-0.659),but not with the scores of VAS-back(p=0.792).The R-CSA was correlated with the scores of VAS-leg(p=0.001,r=0.713),ODI(p=0.000,r=0.741)and JOA(p=0.001,r=-0.694),but not with the scores of VAS-back(p=0.843).Conclusion.The degree of thickening in sciatic nerve were correlated with parts of clinical symptoms in patients with LDH.Part?Correlation between the recovery of sciatic nerve and the improvement rate of clinical symptoms after surgery in patients with lumbar disc herniationBackground.The treatment strategies for patients with lumbar disc herniation mainly include conservative treatment and surgery.The timing of surgery decides the outcomes and the prognosis.Swollen nerve roots were generally observed during surgery for LDH,which seems to be closely associated with severity of pre-operative symptoms,and may serve as an indicator for surgical outcomes.Objective.To identify the correlation between the changes in sciatic nerve and the prognosis of surgical treatment in patients with LDH.Methods.The general data,sonographic images,Visual Analogue Scores(including pain in back and leg),Japanese Orthopaedic Association Scores-lumbar,the Oswestry Disability Index and other imaging materials pre/post-operatively of LDH in patient were collected retrospectively in Xijing Hospital of the Air Force Military Medical University from June 1,2017 to March 1,2018.The correlation between the changes of sciatic nerve and clinical features,as well as clinical prognosis of patients were also identified.Results.The IR-DIA were correlated with the improvement rate of scores of VAS-leg(p=0.000,r=0.824),JOA(p=0.000,r=0.746)and ODI(p=0.000,r=0.768),but not with the scores of VAS-back(p=0.836).The IR-CSA were correlated with the improvement rate of scores of VAS-leg(p=0.000,r=0.872),JOA(p=0.000,r=0.768)and ODI(p=0.000,r=0.784),but not with the scores of VAS-back(p=0.827).Conclusion.For patients with LDH,the changes in sciatic nerve were closely related to the improvement rate of some symptoms,which was meaningful for the prognosis of surgical treatment. |
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