Author to whom correspondence should be sent:
Dr. SAMOLSKY DEKEL Boaz Gedaliahu
Department of Medicine and Surgery Sciences, University of Bologna,
via Massarenti n. 9, 40138, Bologna, Italy
Phone 0039 051 6363087
Fax 0039 051 6364439
Email boaz.samolskydekel@unibo.it
The submission includes:
Cover letter
Title page
Abstract
Manuscript (word count: 4484)
N° of References: 35
N° of Tables: 5
N° of Figures: 2
Abstract
Background. Differential diagnosis of Low-back pain (LBP) is complex and
a prominent health care issue at all Health-care levels; guidance may
come from patients’ history cues and clinical examination signs. Human
and animal studies report that lumbar radicular pain (LRP) may be
diagnosed, at all care settings, by the evaluation of subjective
responses of injured lumbar nerves to a strain applied at the buttock.
The Buttock Applied Strain (BUAS-test) may guide the differential
diagnosis of LBP. Following an ex-adiuvantibus criterion,
clinical improvement of LRP, diagnosed with the BUAS-test and
congruently treated, may support this test diagnostic ability.
Methods. Among 258 LRP patients, positive at V1, to the BUAS-test
(with/without positive Straight-Leg-Raising-Test, SLRT), the effect of
gabapentin on painDETECT (PD) questionnaire and BPI outcomes was
quantified in the follow-up visit (V2). We hypothesized that, at V2,
>50% of the sample would present negative PD-outcome,
significant (t-Test), and ≥2 points V2-V1 differences for each the
BPI-item’s score. Multinomial-Logistic-Regression (MLR) and
χ2 analyses were used to evaluate the PD-V2-outcomes’
dependence upon independent variables.
Results. Of the sample, 77% reported Negative PD-V2-outcome. V2-V1
differences of all BPI-items were significant and >2
points. PD-V2-outcomes showed significant associations with SLRT-V1 and
PD-V1, respectively, but not with gender, age group, or pain-site. MLR
showed a significant relationship between SLRT-V1 and PD-V2 outcomes.
Conclusions. Among LRP patients, diagnosed by the BUAS-test and treated
with gabapentin, all prespecified endpoints were reached. These results
may be considered a piece of ex-adiuvantibus evidence for the
BUAS-test ability to diagnose LRP. While positive BUAS-test implies
potential LRP, the co-presence with positive SLRT may imply a severer
LRP condition. Further prospective research, in different settings and
direct clinical measures, is needed.
Key words: LBP; PainDETECT; SLRT; BUAS test; gabapentin; Lumbar
Radicular Pain; BPI