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Scratch Collapse Test And Patient-reported Outcomes After Lower Extremity Nerve Decompression Surgery
Syeda H. Ahmed, MD
1, Ramin Shekouhi, MD
2,
Mark A. Maier, MD2, Harvey Chim, MD
2.
1University of Florida, Gainesville, FL, USA,
2Louisiana State University Health Sciences Center, New Orleans, LA, USA.
PURPOSE: This study evaluates the scratch collapse test (SCT) as a diagnostic tool for nerve compression and assesses functional and patient-reported outcomes (PROMs) in a cohort undergoing lower extremity nerve decompression (LEND) with at least one year of follow-up.
METHODS: Forty-five consecutive patients who underwent LEND surgery were reviewed. Patients were assessed using standardized PROMs, including Visual Analog Scale (VAS), Patient Satisfaction Scale (PSS), Norfolk QOL-DN questionnaire, SF-36, Lower Extremity Functional Scale (LEFS), and Michigan Neuropathy Screening Instrument (MNSI). Data were analyzed using t-tests and linear regression models.
RESULTS: The SCT was positive in 100% of patients. Postoperatively, sensory deficits improved in 73.3% of patients, and muscle weakness improved in 35.6%. Data regarding PROMs was available for 40.0% of patients. The mean post-operative VAS, PSS, and Norfolk QOL-DN scores were 4.8 ± 2.8, 3.6 ± 1.6, and 38.1 ± 29.5, respectively. The mean SF-36 physical and mental component scores were 47.9 ± 31.8 and 57.7 ± 29.1, respectively. The mean scores for the LEFS and MNSI were 47.5 ± 24.5 and 5.2 ± 3.2, respectively. Patients with multiple nerve compression sites had significantly lower SF-36 physical limitation scores than those with single nerve involvement (P < 0.05). Sciatic nerve compression was significantly associated with lower post-operative VAS scores (P < 0.05).
CONCLUSION: SCT was effective for diagnosis of nerve compression sites. Improvements in pain, sensory function, and motor deficits were observed. Patients with multiple nerve compression sites had poorer SF-36 domain scores, highlighting the need for a multidisciplinary rehabilitation approach.
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