MRI and Sciatica: Disc Herniation Size Doesn't Matter

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MRI and Sciatica: Disc Herniation Size Doesn't Matter

It is common for patients with sciatica to have varying amounts of disc herniation if a pathological disc is the cause of the pain. This study sought to assess how self report of symptoms and clinical findings can be explained by the degree of disc displacement on magnetic resonance imaging (MRI).

MRIs from 160 patients with unilateral sciatic pain were evaluated. The degree of disc displacement, neural enhancement, and nerve root compression was evaluated from the MRIs. Using various clinical outcome measures, patients reported back and leg pain symptom parameters, and of disability. Clinicians collected a battery data during a clinical examination of every patient. Correlations of symptoms and signs with MRI findings were calculated using statistical methods.
The degree of disc displacement in magnetic resonance imaging did not correlate with any subjective symptoms, nor did nerve compression. Magnetic resonance imaging classification was associated with straight leg raising restriction. In regression, analysis, straight leg raising restriction was best explained with a simple classification of nonherniations versus herniations. The authors suggest that a pain mechanism generating from the intervertebral disc other than nerve root entrapment probably generates the symptoms experienced by sciatica patients.
Karppinen J, Malmivaara A, Tervonen O, et al. Severity of symptoms and signs in relation to magnetic resonance imaging findings among sciatic patients. Spine 2001:26, pp. E149-E154.