Disease relevance of Sciatica

• Reversible cause of back pain and sciatica in rheumatoid arthritis: an apophyseal joint cyst [1].
• Low back pain and sciatica have been treated with peridural local anesthetics for over 80 years and with epidural and subarachnoid steroid injections for a quarter of a century [2].
• SUMMARY OF BACKGROUND DATA: It has been suggested that a high phospholipase A2 enzyme activity in herniated disc tissue could be significant in abnormal states such as sciatica and discogenic pain [3].
• Spinal epidural abscess following steroid injection for sciatica. Case report [4].
• Disc prolapse presenting with sciatica may be associated with enhancement of the symptomatic nerve root following magnetic resonance imaging (MRI) with intravenous gadolinium (Gd)-DTPA [5].

High impact information on Sciatica

• CONCLUSIONS: Although epidural injections of methylprednisolone may afford short-term improvement in leg pain and sensory deficits in patients with sciatica due to a herniated nucleus pulposus, this treatment offers no significant functional benefit, nor does it reduce the need for surgery [6].
• METHODS: In a randomized, double-blind trial, we administered up to three epidural injections of methylprednisolone acetate (80 mg in 8 ml of isotonic saline) or isotonic saline (1 ml) to 158 patients with sciatica due to a herniated nucleus pulposus [6].
• PURPOSE: To evaluate whether the COL9A3 tryptophan allele (Trp3 allele) is associated with a specific radiologic phenotype among patients with sciatica [7].
• PURPOSE: To evaluate the prevalence and radiologic findings of annular tear (especially of contrast material enhancement), bulging disk, and disk herniation on T2-weighted and gadolinium-enhanced T1-weighted magnetic resonance (MR) images in people without low back pain (LBP) or sciatica [8].
• Efficacy of epidural steroid injections for low-back pain and sciatica: a systematic review of randomized clinical trials [9].

Chemical compound and disease context of Sciatica

• In this report, our patient presented with sciatica that responded poorly to epidural steroid injection and only transiently to piriformis injection [10].
• MATERIALS AND METHODS: Thirty-six volunteers without LBP and/or sciatica (18 with no symptoms in their lifetime and 18 who were pain free for at least 6 months) were examined with sagittal and axial T2-weighted fast spin-echo (SE) and sagittal gadolinium-enhanced T1-weighted fast SE imaging [8].
• Comparison of injectable formulations of tiaprofenic acid and ketoprofen in acute lumbar sciatica. Single-blind randomised trial [11].
• METHODS: Ten healthy individuals with sciatica underwent a short insulin tolerance test before and twice following (at 24 h and 1 week) a caudal epidural containing 80 mg triamcinolone [12].
• In this randomized, double-blind, double-dummy trial, 113 patients with acute sciatica were treated with a single 15-mg dose of meloxicam given intramuscularly (n = 54) or orally (n = 59) [13].

Biological context of Sciatica

• STUDY OBJECTIVES: Pilot study comparing the short-term efficacy on pain and functional impairment of nerve root sheath versus interspinous glucocorticoid injections in patients admitted to a French rheumatology department for disk-related sciatica or femoral neuralgia [14].
• INTERVENTION: Electrodiagnostic testing and nerve conduction studies reveal abnormal conduction velocities in cases of peripheral neuropathy such as Charcot-Marie-Tooth Disease. CONCLUSION: Sciatica and leg weakness may be due to a variety of causes, including nerve root entrapment and peripheral neuropathy [15].

Anatomical context of Sciatica

• We report a 33-year-old man with sciatica, previously diagnosed as hereditary multiple exostoses, presenting with multiple peripheral nerve compressions [16].
• Serum and cerebrospinal fluid (CSF) concentrations of ketoprofen have been measured in 36 patients hospitalised for sciatica [17].
• STUDY DESIGN: The present study attempts to document deep vascular abnormalities of the lower extremity in cases of sciatica secondary to discal herniation using Tc-99m methylene diphosphonate angiography [18].
• Barr published an article on the intervertebral disc lesion in the New England Journal of Medicine. That article fundamentally changed the popular understanding of sciatica at that time, and for this work Mixter is generally credited by his contemporaries as being the man who best clarified the relation between the intervertebral disc and sciatica [19].
• CONCLUSIONS: Patients with disc herniation and sciatica have increased concentrations of neurofilament protein and S-100 in the cerebrospinal fluid, which indicates damage of axons and Schwann cells in the affected nerve root [20].

Gene context of Sciatica

• METHODS: Eighteen patients with SSc were compared with two control groups: 16 patients with rheumatoid arthritis (RA) and 23 patients with mechanical sciatica [21].
• Lipopolysaccharide is a potent inducer of tumor necrosis factor-alpha (TNF-alpha), which is thought to play an important role in the pathophysiology of sciatica [22].
• There was a statistically significant difference between levels of production of IL-6 and IL-8 in the sciatica and low back pain groups (p < 0.006 and p < 0.003, respectively) [23].
• The present study therefore further indicates the importance of TNF-alpha in sciatica due to disc herniation and the possible therapeutic use of a TNF-alpha inhibitor for this condition [24].
• Magnetic resonance imaging findings in relation to the COL9A2 tryptophan allele among patients with sciatica [25].

Analytical, diagnostic and therapeutic context of Sciatica

• Comparison of caudal steroid epidural with targeted steroid placement during spinal endoscopy for chronic sciatica: a prospective, randomized, double-blind trial [26].
• Levels of four papaya cysteine proteinases were determined in Chymodiactin, a pharmaceutical preparation of chymopapain (EC 3.4.22.6) used in chemonucleolysis for the treatment of sciatica [27].
• We have measured the concentrations of pirprofen at various times in plasma and cerebrospinal fluid (CSF) samples, drawn during diagnostic myelography from 28 patients affected by sciatica [28].
• Lamotrigine for intractable sciatica: correlation between dose, plasma concentration and analgesia [29].
• Data were obtained from 68 healthy volunteers and >800 patients with conditions such as arthritis, sciatica and lumbago who were treated with intramuscular injections of meloxicam compared with oral formulations [30].

References