The use of electroneurography for differentiation of neuropathic pain component in patients with chronic pain syndromes of the lumbar-sacral localization

Abstract

Aim of research: to study the possibility to use the separate methods of electroneurography, namely nociceptive flexor reflex (NFR) for determination of neuropathic component of pain in patients with the chronic pain syndrome of lumbar-sacral localization.Materials and methods: 103 patients with the chronic vertebrogenic lumbar-sacral pain syndrome (CVLSPS) and 30 practically healthy persons were examined. According to the results of clinical-neurological examination all patients were divided in groups that corresponded to the first four groups of Classification of spine disease of Quebec special commission (CSDQSC). The determination of state of peripheral neuromotor apparatus was realized using electroneurography of the calf nerve, after that the NFR study was realized.Results: the speeds of impulse passing on the calf nerve did not differ between patients with CVLSPS and the control group. The reliable decrease of pain threshold (PT) (7,65±1,77), reflex threshold (RT) (9,67±2,0) and ratio of pain threshold/reflex threshold (PT/RT) (0,77±0,11) were revealed in the group of patients with CVLSPS comparing with the group of practically healthy examined persons (8,90±0,94, 10,38±1,05 and 0,86±0,07 respectively). At the analysis of NFR parameters between the groups of patients with CVLSPS the statistically significant differences in PT and RT parameters were not found. PT/RT ratio was statistically reliably lower in IV group (0,73±0,12) comparing with other three groups of patients.Conclusions: patients with CVLSPS have the reliably lower values of PT and RT and PT/RT ratio comparing with practically healthy persons. PT/RT ratio is the most specific parameter of NFR for differentiation of nociceptive and neuropathic pain components