Neri symptom in osteochondrosis, sciatica and myelopathy
Symptom Neri was an Italian neurologist examined in 1882 when he discovered the relationship between low back pain and flexion of the head in patients with degenerative disc disease of the lumbar spine.
To run the test, it is necessary to bend down the head of the patient in the supine position, the chest. While the person in the presence of sciatica occur severe pain in the lower back. Their appearance is due to additional irritation of the membranes of the spinal cord at the exit from them inflamed spinal nerves.
When there is pathology
Appears Neri Symptom in the following diseases:
- Myeloradiculopathy in the lumbar spine, in which there is impairment of the nerve roots L5-S1. In pathology there is a loss of tendon reflexes in the lower limbs (Achilles, knee), impaired sweating, loss of skin sensation, pathological changes in the affected limb. When performing laboratory tests of cerebrospinal fluid, it can be seen the red blood cells and white blood cells;
- Radiculitis (inflammation of nerve roots) occurs in osteochondrosis of the spine combined with intervertebral hernia, tumors of nerve roots, injuries of the spine;
- Muscle spasm of the muscles of the lower back when hypothermia is accompanied by involvement of the spinal nerves, passing in the thickness of muscle tissue. In such a situation appears Neri symptom due to the compression and elongation of nerve fibers
- In osteochondrosis of the lumbar 2-4 degree a symptom of the tension is formed when reducing the height of the intervertebral disc at 2/3 height.
each person Has their own pain threshold. It can be strong and weak, which does not allow to assess the syndrome in the generalized criteria. As a result, in each case to analyze the severity of the pathology should physician individually.
Symptoms syndrome tension of paravertebral muscles
Symptoms syndrome tension of paravertebral muscles (Lasegue, Wasserman, Neri) in osteochondrosis are formed due to:
- Bulging intervertebral disc
- Fusion of the vertebrae
- the Presence of bone osteophytes;
- inflammation of the muscular-ligamentous apparatus.
The Pathogenetic mechanism of symptom Neri is the infringement of the nerve roots in the segments L3-S1 (3 lumbar 1 to sacral vertebra). Due to the gradual displacement of nucleus pulposus, the progression of its destructive changes, degenerative changes of the soft tissues gradually gaps hyaline plates, which protrude beyond the functional spinal segment.
Compression of the nerve root occurs frequently in posterior intervertebral disc prolapse. In this situation the syndrome is characterized by severe pain in the lower back.
Versions of pain in the pathology of the lumbar spine:
- severe pain in the loins upon the slightest movement almost always causes the tension of the paravertebral muscles (the positive symptoms of Lasegue, Neri, Wasserman). Its cause in most cases is the infringement of the nerve roots (Nogata);
- low-grade pain within 3 weeks form the false negative symptoms of tension. Over time the person has pain in the lower extremities, which persists throughout the disease;
- Pronounced neurological symptoms (vegetative-vascular, radicular) with minor pain are observed in a lateral direction of the intervertebral hernia. In this disease syndrome tension Neri may not be observed in the protrusion of the intervertebral disc is not more than 10 mm.
Thus, the Neri syndrome is an important prognostic sign, allowing you to start timely treatment of vertebral pathology. In combination with other syndromes tension (Lasegue, Wasserman) it can be used for the assessment of therapy of the disease.