Altered lower limb vascular perfusion in patients with sciatica secondary to disc herniation

Area of Science:

• Vascular Medicine
• Nuclear Medicine
• Orthopedics

Background:

• Thermography has suggested reduced skin temperature in sciatica patients.
• Previous studies have not assessed total vascular flow or muscular perfusion in sciatica.
• This study investigates deep vascular abnormalities in sciatica secondary to disc herniation.

Purpose of the Study:

• To document deep vascular abnormalities in the lower extremity of sciatica patients using Tc-99m methylene diphosphonate angiography.
• To compare vascular abnormalities with the contralateral extremity and healthy controls.
• To assess the clinical utility of this imaging technique.

Main Methods:

• Isotopic angiography of the posterior thigh was performed on 30 sciatica patients, 16 with chronic low back pain, and 31 controls.
• Intravenous injection of Tc-99m methylene diphosphonate was used.
• Vascular differences were quantified as a percentage compared to the non-painful side or control values.

Main Results:

• Vascular abnormalities were found in 80% of sciatica patients and 68.7% of low back pain patients.
• The median blood flow difference was -12.5% in sciatica patients, +4% in low back pain patients, and +2.9% in controls.
• Statistically significant differences were observed between the sciatica group and other groups; no clinical correlation was found.

Conclusions:

• Significant vascular perfusion abnormalities occur in sciatica patients with disc herniation.
• These abnormalities might be linked to altered sympathetic vascular autoregulation.
• Tc-99m methylene diphosphonate angiography is a valuable tool for assessing these vascular changes.