Ik. Pople et Hb. Griffith, PREDICTION OF AN EXTRUDED FRAGMENT IN LUMBAR DISC PATIENTS FROM CLINICAL PRESENTATIONS, Spine (Philadelphia, Pa. 1976), 19(2), 1994, pp. 156-158
To determine whether the presence of an extruded lumbar disc prolapse
could be predicted from clinical symptoms, the authors compared the re
lative proportions of back and leg pain, with operative findings in a
prospective observational study of 100 lumbar discectomy patients. All
cases were assessed by an independent observer, blind to the knowledg
e of the operative findings. Of the 58 men and 42 women (mean age 42,
range 19-75), 47 patients had a subligamentous disc protrusion and 53
had an extruded disc fragment. Of 27 patients who presented with leg p
ain only, 26 (96%) were found subsequently to have an extruded fragmen
t. Patients with an extruded fragment had a significantly higher propo
rtion of leg:back pain (median 99:1) than those with a subligamentous
disc protrusion (median 75:25, P < 0.001). Patients with leg pain only
and those with a marked predominance of leg pain over back pain have
a high probability of harboring an extruded disc fragment.