Low Back Pain, Lumbosacral Radiculopathy, Sciatica
Conditions
Brief summary
Retrospective, observational, single-centre study conducted at Nice University Hospital (Pasteur 2), Department of Diagnostic and Interventional Radiology. Objective: to assess the prevalence of three CT signs sought next to the clinically suspected nerve root in patients with low-back sciatica referred for CT-guided foraminal/peri-radicular infiltration: (1) nerve-root size asymmetry/hypertrophy, (2) peri-radicular infiltration, and (3) spontaneous root hyperdensity. Hypothesis: these signs are associated with the suffering nerve root responsible for the clinical presentation. Pre-infiltration planning CT scans (period 30 Jan 2024 - 11 Jul 2024) are reviewed by the operating radiologists (4th-, 5th- and 6th-year residents). Target enrollment: 400 patients. Data analysed to date: 104 patients / 105 infiltrations. Preliminary prevalence: root asymmetry/hypertrophy 45.5%; peri-radicular infiltration 50.5%; spontaneous hyperdensity 23.8%; at least 2 of 3 signs 38.6%; all 3 signs 16.8%. Mean age 65 years (range 25-93); approximately 62 women / 42 men; predominant levels L4-L5 and L5-S1.
Interventions
DIAGNOSTIC_TESTPre-infiltration lumbar planning CT scan - reading of the three nerve-root signs
Retrospective analysis of the planning CT scans performed before CT-guided foraminal/peri-radicular infiltration. Reading by the operating radiologists (4th-, 5th- and 6th-year radiology residents) assessing, next to the symptomatic nerve root, three signs (present/absent): root size asymmetry/hypertrophy; peri-radicular infiltration; spontaneous hyperdensity. No additional procedure for the patient.
Sponsors
Centre Hospitalier Universitaire de Nice
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult (\>= 18 years) * Low-back sciatica / radicular pain with a systematized distribution * Referred for CT-guided foraminal or peri-radicular infiltration at Pasteur 2 Hospital (Nice) between 30 Jan 2024 and 11 Jul 2024. * Available and interpretable pre-infiltration planning CT
Exclusion criteria
* Planning CT missing or not interpretable * Missing data on the three studied signs * Radicular pain of tumoral, infectious or recent traumatic origin * Spinal history precluding analysis of the studied root
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of nerve-root size asymmetry / hypertrophy on CT | At inclusion | Proportion of patients showing, on the pre-infiltration planning CT, size asymmetry (hypertrophy) of the nerve root next to the clinically suspected root (present/absent). |
| Prevalence of peri-radicular infiltration on CT | At inclusion | Proportion of patients showing, on the pre-infiltration planning CT, infiltration of the peri-radicular tissues next to the clinically suspected root (present/absent). |
| Prevalence of spontaneous nerve-root hyperdensity on CT | At inclusion | Proportion of patients showing, on the pre-infiltration planning CT, spontaneous hyperdensity of the nerve root next to the clinically suspected root (present/absent). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pre-operative pain (VAS) | Before the infiltration (Day 0). | Visual analogue scale for pain, from 0 (no pain) to 10 (worst imaginable pain); a higher score indicates more severe pain. |
| Pre-operative quality of life (EQ-5D) | Before the infiltration (Day 0). | EQ-5D questionnaire covering 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Collected before the infiltration; used as the baseline health-state assessment. |
Countries
France
Contacts
CONTACTkevin desalos
Outcome results
None listed