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Inflammatory biomarkers do not distinguish between patients with sciatica and referred leg pain within a primary care population: results from a nested study within the ATLAS cohort.
- Source :
-
BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2019 May 10; Vol. 20 (1), pp. 202. Date of Electronic Publication: 2019 May 10. - Publication Year :
- 2019
-
Abstract
- Background: There is increasing interest in the role of pro-inflammatory cytokines in the pathogenesis of sciatica and whether these could be potential targets for treatment. We sought to investigate serum biomarker levels in patients with low back-related leg pain, including sciatica.<br />Methods: Primary care consulters aged > 18 with low back-related leg pain were recruited to a cohort study (ATLAS). Participants underwent a standardised clinical assessment, lumbar spine MRI and a subsample (n = 119) had samples taken for biomarker analysis. Participants were classified having: a) clinically confirmed sciatica or referred leg pain, and then subdivided into those with (or without) MRI confirmed nerve root compression due to disc prolapse. Seventeen key cytokines, chemokines and matrix metalloproteinases (MMPs) implicated in sciatica pathogenesis including TNFα and IL-6, were assayed in duplicate using commercial multiplex detection kits and measured using a Luminex suspension array system. Median biomarker levels were compared between the groups using a Mann Whitney U test. Multivariate logistic regression analysis was used to investigate the association between clinical measures and biomarker levels adjusted for possible confounders such as age, sex, and symptom duration.<br />Results: No difference was found in the serum level of any of the 17 biomarkers tested in patients with (n = 93) or without (n = 26) clinically confirmed sciatica, nor between those with (n = 44) or without (n = 49) sciatica and MRI confirmed nerve root compression.<br />Conclusion: In this cohort, no significant differences in serum levels of TNFα, IL-6 or any other biomarkers were seen between patients with sciatica and those with back pain with referred leg pain. These results suggest that in patients with low back-related leg pain, serum markers associated with inflammation do not discriminate between patients with or without clinically confirmed sciatica or between those with or without evidence of nerve root compression on MRI.
- Subjects :
- Adult
Aged
Biomarkers blood
Case-Control Studies
Diagnosis, Differential
Feasibility Studies
Female
Humans
Intervertebral Disc Displacement blood
Intervertebral Disc Displacement complications
Leg
Longitudinal Studies
Low Back Pain blood
Lumbosacral Region diagnostic imaging
Magnetic Resonance Imaging
Male
Middle Aged
Pain, Referred blood
Primary Health Care statistics & numerical data
Referral and Consultation statistics & numerical data
Sciatica blood
Sciatica complications
Inflammation Mediators blood
Intervertebral Disc Displacement diagnosis
Low Back Pain etiology
Pain, Referred etiology
Sciatica diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2474
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC musculoskeletal disorders
- Publication Type :
- Academic Journal
- Accession number :
- 31077179
- Full Text :
- https://doi.org/10.1186/s12891-019-2604-2