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H-REFLEX IN THE DIAGNOSIS OF LUMBO-SACRAL RADICULOPATHY

Material: This work comprised fifteen patients suspected of having unilateral fifth lumbar root (L5) and/or first sacral root (S1) radiculopathy secondary to spinal nerve compression. Ten healthy subjects matched in age, sex and height served as controls. Diagnosis was confirmed clinically and with radiographic assessment. Method: H-reflex was done bilaterally to both symptomatic and asymptomatic sides from both soleus and gastrocneumius muscles according to Shahani (1986). Peak to peak amplitude and latency was recorded. Results: On the symptomatic side a significant prolongation was found in the latency of the H-reflex as elicited from both soleus and gastrocneumius muscles on the symptomatic side of patients versus the asymptomatic side or the control group p<0.05. There was a highly significant reduction p<0.001 of the amplitude of the motor evoked response from both muscles as well. However, abnormal H-reflex was also encountered in the non-symptomatic side. The H-reflex recorded from the soleus was more sensitive than from the gastrocnemius muscle. All patients with neurological deficit showed prolonged latency and reduced amplitude. Conclusion: Both techniques, measuring H-reflex from soleus or gastrocnemius are complementary to each other and the positive results of any of them could be enough for the diagnosis of radiculopathy.