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Spine:
POST ACCEPTANCE, 15 January 2013 doi: 10.1097/BRS.0b013e318286b7dd Clinical Case Series: PDF Only Do L5 and S1 nerve root compressions produce radicular pain in a dermatomal pattern?Taylor, CS BSc, MBBS; Coxon, A PhD, MBCS, MICR; Watson, P BSc; Greenough, CG MD, MChir, FRCSPublished Ahead-of-Print Abstract Structured Abstract: Study Design. Observational case series. Objective. To compare the pattern of distribution of radicular pain with published dermatome charts. Summary of Background Data. Dermatomal charts vary, and previous studies have demonstrated significant individual subject variation. Methods. Patients with radiologically and surgically proven nerve root compression caused by prolapsed intervertebral disc completed computerised diagrams of the distribution of pain and pins and needles. 98 patients had L5 compressions and 83 had S1 compressions. Results. The distribution of pain and pins and needles did not correspond well with dermatomal patterns. Of those patients with L5 NRC, only 22 (22.4%) recorded any hits on the L5 dermatome on the front, and only 60 (61.2%) on the back with only 13 (13.3%) on both. Only 1 (1.0%) patient placed >50% of their hits within the L5 dermatome. Of those patients with S1 NRC, only 3 (3.6%) recorded any hits on the S1 dermatome on the front, and only 64 (77.1%) on the back with only 15 (18.1%) on both. No patients placed >50% of their hits within the S1 dermatome. Regarding pins and needles, 27 (29.7%) of L5 patients recorded hits on the front alone, 27 (29.7%) on the back alone and 14 (15.4%) on both. 19 (20.9%) recorded >50% of hits within the L5 dermatome. 3 (3.6%) S1 patients recorded hits on the front alone, 44 (53.0%) on the back alone and 18 (21.7%) on both. 12 (14.5%) recorded >50% of hits within the S1 dermatome. Conclusion. Patient report is an unreliable method of identifying the anatomical source of pain or paraesthesia caused by nerve root compression. This is a spontaneous Email from a PT from out of state. I saw her once and gave a strong letter suggesting a work up for discitis (infection in the disc) and this or a lower thoracic herniateion after testing with provocation, first in neutral, then extension, then child pose, tapping T1-S5. She had 2 fairly normal MRI’s yet severe sciatica for 2 years, obviously in significant duress, runs a large practice, has a 3 year old and a one year old and this really affects her ability to be a mom.
“…I have felt improvment no doubt due to seeing you. I have more range of motion without such a stiff end range in every position I tried. I would have unrelievable pressure that seems you have really helped. I do think the underlying cause you are probably right on track with the discitis. After researching it, it makes more since. This is the best I have felt in over a year, and the cheapiest thing yet. …Shirley Sarhmann has a great outlook on the effects on mal alignment and recoil etc.…If someone would put her methods and yours together, it would be amazing. In fact that was the approach I took. I had two 270 pound men who were thinking of surgery become pain free by using your and her techniques. And they lost no weight….THank you, Thank you, Thank you. And I will now return any help i can to you. “ |
Dr. Jerry Hesch, DPT, MHS, PTMarried with 4 grown kids. Earned my Doctorate at A.T. Still University in Tempe, AZ, MHS at the University of Indianapolis and my BS PT at University of New Mexico. I enjoy working with my hands and particularly making glass objet d'art. Powered by Calendar Labs Archives
August 2016
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