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

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 radicul...

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Autores principales: Mazzocchio, Riccardo, Scarfò, Giovanni Battista, Mariottini, Aldo, Muzii, Vitaliano Francesco, Palma, Lucio
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2001
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC60003/
https://www.ncbi.nlm.nih.gov/pubmed/11722799
http://dx.doi.org/10.1186/1471-2474-2-4
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author Mazzocchio, Riccardo
Scarfò, Giovanni Battista
Mariottini, Aldo
Muzii, Vitaliano Francesco
Palma, Lucio
author_facet Mazzocchio, Riccardo
Scarfò, Giovanni Battista
Mariottini, Aldo
Muzii, Vitaliano Francesco
Palma, Lucio
author_sort Mazzocchio, Riccardo
collection PubMed
description 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.
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spelling pubmed-600032001-11-27 Recruitment curve of the soleus H-reflex in chronic back pain and lumbosacral radiculopathy Mazzocchio, Riccardo Scarfò, Giovanni Battista Mariottini, Aldo Muzii, Vitaliano Francesco Palma, Lucio BMC Musculoskelet Disord Research Article 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. BioMed Central 2001-10-08 /pmc/articles/PMC60003/ /pubmed/11722799 http://dx.doi.org/10.1186/1471-2474-2-4 Text en Copyright © 2001 Mazzocchio et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Research Article
Mazzocchio, Riccardo
Scarfò, Giovanni Battista
Mariottini, Aldo
Muzii, Vitaliano Francesco
Palma, Lucio
Recruitment curve of the soleus H-reflex in chronic back pain and lumbosacral radiculopathy
title Recruitment curve of the soleus H-reflex in chronic back pain and lumbosacral radiculopathy
title_full Recruitment curve of the soleus H-reflex in chronic back pain and lumbosacral radiculopathy
title_fullStr Recruitment curve of the soleus H-reflex in chronic back pain and lumbosacral radiculopathy
title_full_unstemmed Recruitment curve of the soleus H-reflex in chronic back pain and lumbosacral radiculopathy
title_short Recruitment curve of the soleus H-reflex in chronic back pain and lumbosacral radiculopathy
title_sort recruitment curve of the soleus h-reflex in chronic back pain and lumbosacral radiculopathy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC60003/
https://www.ncbi.nlm.nih.gov/pubmed/11722799
http://dx.doi.org/10.1186/1471-2474-2-4
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