H-reflex in the diagnosis of lumbosacral radiculopathy

ABSTRACT

This work comprised fifteen patients suspected of having unilateral fifth lumbar root [L[5]] and/or first sacral root [S[1]] 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. 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. 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. 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