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New way to diagnose sciatica may point to a different cause

LOS ANGELES (February 1, 2005) For the last 70 years, a damaged disc in the lower back has been widely accepted as the most common cause of sciatica a condition where the sciatic nerve is pinched, causing pain to radiate down the leg. As a result, treatment for sciatica is based on diagnosis of a damaged disc, despite the fact that nerves cannot be viewed with routine imaging tests. Consequently, over one million patients each year undergo magnetic resonance imaging scans (MRI) for sciatica and many are told there is no obvious cause for their pain.

Now, researchers at Cedars-Sinai Medical Center, the University of California, Los Angeles, and the Institute for Nerve Medicine in Los Angeles, have found that new nerve imaging technology called Magnetic Resonance neurography was effective to reveal that a pinched-nerve in the pelvis called piriformis syndrome caused sciatic leg pain in the majority of patients who had failed diagnosis with an MRI scan and/or who were not treated successfully with surgery. The study, published in the February issue of the Journal of Neurosurgery: Spine, may lead to a better way to diagnose and treat sciatica a condition that affects nearly 40 percent of adults at some point during their lifetime.

"Our study not only found that we can use MR neurography to accurately image the sciatic nerve, but also shows that we can effectively diagnose and treat sciatic pain that is not caused by a herniated or damaged disc," said Aaron Filler, M.D., Ph.D., lead author of the study and a neurosurgeon at the Cedars-Sinai Institute of Spinal Disorders. "When a damaged disc is not causing sciatica, patients should talk to their doctors about special imaging for nerves with MR neurography."

Sciatica occurs when the sciatic nerve is pinched or irritated, causing pain to travel from the buttocks and down the back of the thigh and calf, sometimes extending into the foot. Today, when a patient experiences painful and
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Contact: Kelli Hanley
kelli.hanley@cshs.org
1-310-423-3674
Cedars-Sinai Medical Center
31-Jan-2005


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