Recruitment curve of the soleus H-reflex in chronic back pain and lumbosacral radiculopathy

被引：33

作者：

Mazzocchio R. ^{[1
]}

Scarfò G.B. ^{[1
]}

Mariottini A. ^{[1
]}

Muzii V.F. ^{[1
]}

Palma L. ^{[1
]}

机构：

[1] Istituto di Neurochirurgia, Università di Siena

来源：

BMC Musculoskeletal Disorders | / 2卷 / 1期

关键词：

Spondylolisthesis; Radiculopathy; Chronic Back Pain; Focal Neurological Sign; Recruitment Curve;

D O I：

10.1186/1471-2474-2-4

中图分类号：

学科分类号：

摘要：

Background: Needle EMG may be negative in mild or predominantly sensory lumbosacral radiculopathies. In such cases, an increase in the latency of the soleus H-reflex is a useful diagnostic criterion for establishing sensory fiber compromise at the S1 root level. However, if clinical signs of radicular involvement are lacking, the latency of the H-reflex is normal. We therefore studied the recruitment curve of the soleus H-reflex to investigate whether a change in the electrical threshold for eliciting the H-reflex might be a more sensitive criterion for detecting subclinical S1 root dysfunction. Methods: Clinical and electrophysiological findings from 26 patients with chronic back pain and radiculopathy were compared with data obtained from 40 healthy subjects. Results: An increase in the mean H-reflex threshold was the only abnormal electrophysiological finding in patients with no clinical sign of root injury (58%). A decrease in the mean H-reflex amplitude and a prolongation of H-reflex latency was observed in patients with radicular signs (42%). In both patients groups, F-wave and needle EMG studies were normal. No radiological evidence of S1 root compression was found. Conclusions: The study of the recruitment curve of the soleus H-reflex may be usefully associated to F-wave and needle EMG studies to detect possible S1 root dysfunction in mild lumbosacral radiculopathies. An increase in H-threshold may be the earliest abnormality in the absence of focal neurological signs.

引用

页码：1 / 8

页数：7

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