Neurophysiological Assessment of H-Reflex Alterations in Compressive Radiculopathy

This study aimed to investigate changes in the H-reflex recruitment curve in compressive radiculopathy, specifically assessing differences between symptomatic and asymptomatic limbs in patients with unilateral S1 radiculopathy through derived parameters. A total of 24 volunteers (15 male and 9 female, aged between 22 and 60 years) with confirmed nerve root compression in the L5/S1 segment participated. Nerve root compression was verified through clinical MRI examination and attributed to disc protrusion, spinal canal stenosis, or isthmic spondylolisthesis of L5/S1. Analysis revealed no difference in M-wave threshold intensity between symptomatic and non-symptomatic limbs. However, the H-reflex exhibited a trend toward increased threshold intensity in the symptomatic limb. Notably, a significant decrease in the slope of the H-reflex was observed on the symptomatic side, and the maximal H-reflex amplitude proved to be markedly different between the two limbs. The Hmax/Mmax ratio demonstrated a significant decrease in the symptomatic limb, indicating reduced effectiveness of signal translation. In conclusion, our findings emphasize the importance of H-reflex parameters in evaluating altered recruitment curves, offering valuable insights for neurological examinations. The observed differences in maximal values of M-wave, H-reflex, and their ratio in affected and unaffected limbs can enhance the diagnostic process for lumbosacral unilateral radiculopathy and contribute to a standardized approach in clinical assessments.