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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Laser-evoked potentials: prognostic relevance of pain pathway defects in patients with acute radiculopathy</title><author><name sortKey="Quante, Markus" sort="Quante, Markus" uniqKey="Quante M" first="Markus" last="Quante">Markus Quante</name><affiliation><nlm:aff id="Aff1">Specialist Centre for Spinal Surgery, Hospital Neustadt, Am Kiebitzberg 10, 23730 Neustadt in Holstein, Germany</nlm:aff></affiliation></author><author><name sortKey="Lorenz, Jurgen" sort="Lorenz, Jurgen" uniqKey="Lorenz J" first="Jürgen" last="Lorenz">Jürgen Lorenz</name><affiliation><nlm:aff id="Aff2">Department of Biomedical Engineering, Faculty of Life Sciences, Hamburg-University of Applied Sciences, Hamburg, Germany</nlm:aff></affiliation></author><author><name sortKey="Hauck, Michael" sort="Hauck, Michael" uniqKey="Hauck M" first="Michael" last="Hauck">Michael Hauck</name><affiliation><nlm:aff id="Aff3">Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19777272</idno><idno type="pmc">2899816</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899816</idno><idno type="RBID">PMC:2899816</idno><idno type="doi">10.1007/s00586-009-1169-4</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">000113</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000113</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Laser-evoked potentials: prognostic relevance of pain pathway defects in patients with acute radiculopathy</title><author><name sortKey="Quante, Markus" sort="Quante, Markus" uniqKey="Quante M" first="Markus" last="Quante">Markus Quante</name><affiliation><nlm:aff id="Aff1">Specialist Centre for Spinal Surgery, Hospital Neustadt, Am Kiebitzberg 10, 23730 Neustadt in Holstein, Germany</nlm:aff></affiliation></author><author><name sortKey="Lorenz, Jurgen" sort="Lorenz, Jurgen" uniqKey="Lorenz J" first="Jürgen" last="Lorenz">Jürgen Lorenz</name><affiliation><nlm:aff id="Aff2">Department of Biomedical Engineering, Faculty of Life Sciences, Hamburg-University of Applied Sciences, Hamburg, Germany</nlm:aff></affiliation></author><author><name sortKey="Hauck, Michael" sort="Hauck, Michael" uniqKey="Hauck M" first="Michael" last="Hauck">Michael Hauck</name><affiliation><nlm:aff id="Aff3">Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany</nlm:aff></affiliation></author></analytic><series><title level="j">European Spine Journal</title><idno type="ISSN">0940-6719</idno><idno type="eISSN">1432-0932</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The radicular pain syndrome is a major problem in public health care that can lead to chronic back and leg pain in 30%. Ischalgia and back pain are the most prominent signs of dorsal root affection. Until now, no clinical or neurophysiological test procedure exists that evaluates the function of the dorsal root and predicts the prognosis of patients suffering from RPS. We have recently demonstrated that laser-evoked potentials (LEP) are able to demonstrate dorsal root damage. With this study, we investigated 54 patients with acute radicular symptoms and compared LEP parameters (side to side difference of latency and amplitude, transformed to a <italic>z</italic>-score) with their state of health after 3 months to calculate their predictive value for outcome prognosis. Most significantly, the latency difference between the LEP of the affected dermatome relative to the contralateral healthy dermatome was able to predict the prognosis. Latency <italic>z</italic> score above two demonstrates a 91% specificity (33% sensitivity) for a poor outcome at 3 months. A significant relation between amplitude changes and the main outcome measure could not be shown. Only extreme changes (<italic>z</italic> score >10) in amplitude show a high specificity for the persistence of ischialgia in particular (specificity 0.94; sensitivity 0.35). All other parameters, such as clinical scores or other LEP parameters, were not able to predict the outcome of patients. We propose that clinical testing using LEP with latency analysis is a useful tool for estimating the course of disease, so that patients with poor predictive parameters can be treated more invasively at early disease stages to avoid persistence of radiculopathy.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Eur Spine J</journal-id><journal-title-group><journal-title>European Spine Journal</journal-title></journal-title-group><issn pub-type="ppub">0940-6719</issn><issn pub-type="epub">1432-0932</issn><publisher><publisher-name>Springer-Verlag</publisher-name><publisher-loc>Berlin/Heidelberg</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19777272</article-id><article-id pub-id-type="pmc">2899816</article-id><article-id pub-id-type="publisher-id">1169</article-id><article-id pub-id-type="doi">10.1007/s00586-009-1169-4</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Laser-evoked potentials: prognostic relevance of pain pathway defects in patients with acute radiculopathy</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Quante</surname><given-names>Markus</given-names></name><address><phone>+49-4561-544905</phone><fax>+49-4561-544910</fax><email>doktor_markus_quante@yahoo.de</email><email>mquante@schoen-kliniken.de</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Lorenz</surname><given-names>Jürgen</given-names></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Hauck</surname><given-names>Michael</given-names></name><xref ref-type="aff" rid="Aff3">3</xref></contrib><aff id="Aff1"><label>1</label>Specialist Centre for Spinal Surgery, Hospital Neustadt, Am Kiebitzberg 10, 23730 Neustadt in Holstein, Germany</aff><aff id="Aff2"><label>2</label>Department of Biomedical Engineering, Faculty of Life Sciences, Hamburg-University of Applied Sciences, Hamburg, Germany</aff><aff id="Aff3"><label>3</label>Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany</aff></contrib-group><pub-date pub-type="epub"><day>24</day><month>9</month><year>2009</year></pub-date><pub-date pub-type="ppub"><month>2</month><year>2010</year></pub-date><volume>19</volume><issue>2</issue><fpage>270</fpage><lpage>278</lpage><history><date date-type="received"><day>21</day><month>10</month><year>2008</year></date><date date-type="rev-recd"><day>23</day><month>7</month><year>2009</year></date><date date-type="accepted"><day>13</day><month>9</month><year>2009</year></date></history><permissions><copyright-statement>© Springer-Verlag 2009</copyright-statement></permissions><abstract><p>The radicular pain syndrome is a major problem in public health care that can lead to chronic back and leg pain in 30%. Ischalgia and back pain are the most prominent signs of dorsal root affection. Until now, no clinical or neurophysiological test procedure exists that evaluates the function of the dorsal root and predicts the prognosis of patients suffering from RPS. We have recently demonstrated that laser-evoked potentials (LEP) are able to demonstrate dorsal root damage. With this study, we investigated 54 patients with acute radicular symptoms and compared LEP parameters (side to side difference of latency and amplitude, transformed to a <italic>z</italic>-score) with their state of health after 3 months to calculate their predictive value for outcome prognosis. Most significantly, the latency difference between the LEP of the affected dermatome relative to the contralateral healthy dermatome was able to predict the prognosis. Latency <italic>z</italic> score above two demonstrates a 91% specificity (33% sensitivity) for a poor outcome at 3 months. A significant relation between amplitude changes and the main outcome measure could not be shown. Only extreme changes (<italic>z</italic> score >10) in amplitude show a high specificity for the persistence of ischialgia in particular (specificity 0.94; sensitivity 0.35). All other parameters, such as clinical scores or other LEP parameters, were not able to predict the outcome of patients. We propose that clinical testing using LEP with latency analysis is a useful tool for estimating the course of disease, so that patients with poor predictive parameters can be treated more invasively at early disease stages to avoid persistence of radiculopathy.</p></abstract><kwd-group><title>Keywords</title><kwd>Laser-evoked potential</kwd><kwd>Sciatica</kwd><kwd>Dorsal root impairment</kwd><kwd>Prognosis</kwd><kwd>Radiculopathy</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© Springer-Verlag 2010</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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