Advertisement

Sonoelastographic evaluation of the sciatic nerve in patients with unilateral lumbar disc herniation

  • Umut Orkun Çelebi
  • Veysel Burulday
  • Mehmet Faik Özveren
  • Adil Doğan
  • Mehmet Hüseyin Akgül
Scientific Article
  • 29 Downloads

Abstract

Objective

The aim of this study was to compare strain elastography (SE) and shear wave elastography (SWE) findings of the sciatic nerve in patients with unilateral lumbar disc herniation (LDH) and healthy control subjects.

Materials and methods

The study group included patients with complaints of unilateral sciatica for 3–12 months, with foraminal stenosis due to one level of LDH (L4-L5 or L5-S1). An age- and gender-matched control group was formed of healthy subjects. Evaluations were performed on both the axial and longitudinal planes from the bilateral gluteal region using a 5–9 MHz multifrequency convex probe.

Results

There were 40 patients (20 male, 20 female) with a mean age of 43.1 ± 12.7 years in the study group, and 40 healthy subjects (22 male, 18 female) with a mean age of 42.9 ± 10.7 years in the control group (p > 0.05). The sciatic nerve stiffness assessed on both the axial (12.3 ± 3.7 kPA) and longitudinal (14.3 ± 3.8 kPA) planes of the involved side was significantly higher than non-involved side (axial: 6.8 ± 2.1 and longitudinal: 8.3 ± 2.3 kPA) in the patient group (p < 0.001).

Conclusions

Patients with unilateral LDH have increased stiffness of the sciatic nerve compared to healthy control subjects. Although the findings in this preliminary study show that shear wave elastography can detect a change in sciatic nerve stiffness in patients with unilateral LDH, larger studies are required to determine the clinical utility of this technique.

Keywords

Sciatic nerve Ultrasound Peripheral nerve Strain elastography Shear wave elastography Low back pain 

Notes

Funding

There is no funding source for this manuscript.

Compliance with ethical standards

Ethical approval

Local Ethics Committee of Kırıkkale University Medical School (Date 24.02.2017 and No: 03/02). Informed consent was obtained from all the participants.

Conflict of interest

Author Umut Orkun Çelebi declares that he has no conflict of interest.

Author Veysel Burulday declares that he has no conflict of interest.

Author Mehmet Faik Özveren declares that he has no conflict of interest.

Author Adil Doğan declares that he has no conflict of interest.

Author Mehmet Hüseyin Akgül declares that he has no conflict of interest.

Disclosure

There are no financial disclosures of the authors.

References

  1. 1.
    Amin RM, Andrade NS, Neuman BJ. Lumbar disc herniation. Curr Rev Musculoskelet Med. 2017.  https://doi.org/10.1007/s12178-017-9441-4.
  2. 2.
    Kara M, Özçakar L, Tiftik T, Kaymak B, Özel S, Akkuş S, et al. Sonographic evaluation of sciatic nerves in patients with unilateral sciatica. Arch Phys Med Rehabil. 2012;93(9):1598–602.CrossRefPubMedGoogle Scholar
  3. 3.
    Alsaleh K, Ho D, Rosas-Arellano MP, Stewart TC, Gurr KR, Bailey CS. Radiographic assessment of degenerative lumbar spinal stenosis: is MRI superior to CT? Eur Spine J. 2017;26(2):362–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Carrino JA, Lurie JD, Tosteson AN, Tosteson TD, Carragee EJ, Kaiser J, et al. Lumbar spine: reliability of MR imaging findings. Radiology. 2009;250(1):161–70.CrossRefPubMedGoogle Scholar
  5. 5.
    Pfirrmann CW, Dora C, Schmid MR, Zanetti M, Hodler J, Boos N. MR image-based grading of lumbar nerve root compromise due to herniation: reliability study with surgical correlation. Radiology. 2004;230(2):583–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Milano C, Lotti G, Mariconda M. Comparison of CT scan diagnosis and surgical findings in lumbar disk herniation. Ital J Orthop Traumatol. 1991;17(3):401–5.PubMedGoogle Scholar
  7. 7.
    Kara M, Ekiz T, Öztürk GT, Onat ŞŞ, Özçakar L. Heterotopic ossification and peripheral nerve entrapment: ultrasound is a must-use imaging modality. Pain Med. 2015;16(8):1643–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Kara M, Özçakar L, Tan E, Akıncı A. Ultrasonographic imaging of the sciatic nerve in a patient with knife injury. Muscle Nerve. 2015;51(2):303–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Tiftik T, Öztürk GT, Kara M, Türkkan C, Ersöz M, Özçakar L. Ultrasonographic evaluation of sciatic nerves in patients with spinal cord injury. Spinal Cord. 2015;53(1):75–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Uğurlu FG, Tiftik T, Kara M, Türkkan C, Ersöz M, Akkuş S, et al. Ultrasonographic evaluation of the median and sciatic nerves in hemiplegic patients after stroke. Am J Phys Med Rehabil. 2015;94(6):429–35.CrossRefPubMedGoogle Scholar
  11. 11.
    Göktepe AS, Ozçakar L, Kömürcü E, Safaz I, Yazicioğlu K. Sonographic evaluation of the sciatic nerve in patients with lower-limb amputations. Muscle Nerve. 2010;41(6):763–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0: recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J. 2014;14(11):2525–45.CrossRefPubMedGoogle Scholar
  13. 13.
    Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0: recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology, and the American Society of Neuroradiology. Spine (Phila Pa 1976). 2014;39(24):E1448–65.CrossRefGoogle Scholar
  14. 14.
    Wildermuth S, Zanetti M, Duewell S, Schmid MR, Romanowski B, Benini A, et al. Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography. Radiology. 1998;207(2):391–8. Erratum in: Radiology 1998;208(3):834CrossRefPubMedGoogle Scholar
  15. 15.
    Park HJ, Kim SS, Lee SY, Park NH, Chung EC, Rho MH, et al. A practical MRI grading system for cervical foraminal stenosis based on oblique sagittal images. Br J Radiol. 2013;86(1025):20120515.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Chan VW, Nova H, Abbas S, McCartney CJ, Perlas A, Xu DQ. Ultrasound examination and localization of the sciatic nerve: a volunteer study. Anesthesiology. 2006;104(2):309–14. discussion 5ACrossRefPubMedGoogle Scholar
  17. 17.
    Çıracı S, Tan S, Özcan AŞ, Aslan A, Keskin HL, Ateş ÖF, et al. Contribution of real-time elastography in diagnosis of polycystic ovary syndrome. Diagn Interv Radiol. 2015;21(2):118–22.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Santos R, Armada P. Sciatic nerve hardness measurement by using ultrasound elastography. Ultrasound Med Biol. 2013;39(5):S57.Google Scholar
  19. 19.
    Andrade RJ, Nordez A, Hug F, et al. Non-invasive assessment of sciatic nerve stiffness during human ankle motion using ultrasound shear wave elastography. J Biomech. 2016;49(3):326–31.CrossRefPubMedGoogle Scholar
  20. 20.
    Kantarci F, Ustabasioglu FE, Delil S, Olgun DC, Korkmazer B, Dikici AS, et al. Median nerve stiffness measurement by shear wave elastography: a potential sonographic method in the diagnosis of carpal tunnel syndrome. Eur Radiol. 2014;24(2):434–40.CrossRefPubMedGoogle Scholar
  21. 21.
    Kot BC, Zhang ZJ, Lee AW, Leung VY, Fu SN. Elastic modulus of muscle and tendon with shear wave ultrasound elastography: variations with different technical settings. PLoS One. 2012;7(8):e44348.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Ekiz T, Kara M, Özçakar K. Median nerve area measurements using ultrasound: importance of proper technique and interpretation. Am J Phys Med Rehabil. 2017.  https://doi.org/10.1097/PHM.0000000000000854.

Copyright information

© ISS 2018

Authors and Affiliations

  1. 1.Department of RadiologyKirikkale University School of MedicineKirikkaleTurkey
  2. 2.Department of NeurosurgeryKirikkale University School of MedicineKirikkaleTurkey
  3. 3.Department of NeurosurgeryYuksek Ihtisas State HospitalKirikkaleTurkey

Personalised recommendations