Prognostic value of early computed tomography in radiculopathy due to lumbar intervertebral disk herniation. A prospective study.
OBJECTIVE
To prospectively evaluate the relationship between the early computerized tomography (CT) features of disk herniation and the clinical outcome in patients with recent-onset sciatic or femoral neuralgia treated conservatively. Early CT is often used, despite the absence of data on usefulness for predicting outcomes.


METHODS
Of 78 patients with sciatica or femoral neuralgia of less than 1 month's duration, presumably due to a disk herniation, 75 were found by CT to have a disk herniation at the expected level. All patients were treated conservatively. The 60 patients who were reassessed clinically after 3 months were included in the study. Based on the results of the clinical assessment, the patients were classified as having a good outcome (complete or partial recovery) or a poor outcome. CT findings were compared in these two groups.


RESULTS
None of the features of disk herniation studied on the CT scans were significantly correlated with the clinical outcome. A larger herniation or presence of a free fragment was more common in the good outcome group, but the differences were not statistically significant (P= 0.07).


CONCLUSIONS
In this study, early CT scan did not predict the clinical outcome of patients with nerve root pain from lumbar disk herniation. None of the CT criteria was associated with a poor clinical outcome. Early CT scan has no prognostic value in this setting.
Beauvais
Catherine
C
Rheumatology Department, Saint Antoine Hospital, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France. cathbeauv1@aol.com
Wybier
Marc
M
Chazerain
Pascal
P
Harboun
Marc
M
Lioté
Frédéric
F
Roucoulès
Jacques
J
Koeger
Anne Claude
AC
Bellaiche
Laurence
L
Orcel
Philippe
P
Bardin
Thomas
T
Ziza
Jean-Marc
JM
Laredo
Jean Denis
JD
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011843:Radiculopathy / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome