Dynamic electrophysiological examination in patients with lumbar spinal stenosis: Is it useful in clinical practice?

Adamová, Blanka; Voháňka, Stanislav; Dušek, Ladislav

doi:10.1007/s00586-004-0738-9

Cited by 29 publications

(24 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They measured the soleus H-reflex, tibial F-wave, and motor evoked potentials to the abductor hallucis muscle, both before and after the ETT. Only the minimal latency of the tibial F-wave and the latency of the soleus H-reflex exhibited changes after walk loading in patients with LSS (32). In a similar study by Adamova et al (33), increased chronodispersion of the tibial F-wave distinguished LSS patients from polyneuropathy patients and healthy controls.…”

Section: Im Ma Ag Gi In Ng Gmentioning

confidence: 70%

“…These changes consisted of unelicitability or increased latencies, which reversed over the course of 15 minutes following ambulation (31). Adamova et al (32) used an exercise treadmill test (ETT) as a dynamic variable in patients with LSS diagnosed by CT, diabetic polyneuropathy patients, and a group of healthy control patients. They measured the soleus H-reflex, tibial F-wave, and motor evoked potentials to the abductor hallucis muscle, both before and after the ETT.…”

Section: Im Ma Ag Gi In Ng Gmentioning

confidence: 99%

See 1 more Smart Citation

Electrodiagnosis in Lumbar Spinal Stenosis: A Review

Kishner¹,

Gündüz²,

Gupta³

et al. 2010

tftr

View full text Add to dashboard Cite

S Su um mm ma ar ry yLumbar spinal stenosis (LSS) is a narrowing of the spinal canal and/or the neuroforamina through which the spinal cord roots enter and exit. The symptoms of LSS usually begin over the course of several months and include neurogenic claudication. This is characterized by low back pain that radiates down one or both legs producing pain or weakness. LSS can be quite debilitating and can have a profound negative effect on one's activities of daily living and overall quality of life. Imaging studies, such as computed tomography (CT) and magnetic resonance imaging (MRI) are routinely performed in the work-up of suspected LSS. In recent years, there has been much controversy over the actual clinical usefulness of these studies. When compared to electrodiagnostic studies, CT and MRI have been shown to have increased false negative and false positive rates. Electrodiagnostic studies show dynamic physiological neural function and has become a valuable tool in LSS. This information can be used to determine the location and severity of LSS, differentiate LSS from other conditions, and monitor the progression. Electrodiagnostic techniques such as somatosensory evoked potentials, dermatomal somatosensory evoked potentials (DSEPs), and paraspinal mapping (PM) increase both the sensitivity and specificity in diagnosing LSS. DSEPs provide useful information on multi-level, multiple rootlet disease. PM reflects the physiology of nerve roots and has been found to be superior to extremity needle EMG. Electrodiagnostic techniques are becoming the standard in the diagnosis and therapeutic decisions for LSS and other related diseases.Turk J Phys Med Rehab 2010;56:75-80. K Ke ey y W Wo or rd ds s: : Lumbar spinal stenosis, electrodiagnosis, low back pain, lumbar radiculopathy, paraspinal mapping Ö Öz ze et t Spinal kanalda ya da sinir köklerinin geçti¤i nöral foramenlerde daralma lomber spinal stenoz (LSS) olarak adland›r›l›r. LSS yaflam kalitesini belirgin derecede etkileyip engellili¤e neden olabilir. LSS'nin belirtileri aylar içinde ortaya ç›kar. Nörojenik klodikasyon, tek ya da her iki alt ekstremiteye yay›lan bel a¤r›s› ve güçsüzlük LSS'nin semptomlar› aras›nda say›labilir. LSS düflünülen olgularda bilgisayarl› tomografi (BT) ve manyetik rezonans görüntüleme (MRG) gibi yöntemler rutin olarak kullan›lmaktad›r. Fakat bu tetkiklerin LSS tan›s›na katk›s› ile ilgili tart›flma-lar giderek artmaktad›r. Elektrodiagnostik çal›flmalarla karfl›laflt›r›ld›-¤›nda BT ve MRG'nin yalanc› negatif ve yalanc› pozitiflikleri daha fazlad›r. Nöral fonksiyonlar›n gerçek zamanl› durumunu ortaya koyan elektrodiagnostik incelemeler LSS'de oldukça yararl›d›r. Elektrodiagnoz ayr›ca, LSS'nin lokalizasyonu ve fliddeti konusunda bilgi verir; hastal›¤›n ay›r›c› tan›s›nda ve progresyonunun takibinde de yararl›d›r. Somatosensoriyel uyand›r›lm›fl potansiyeller, dermatomal somatosensoriyel uyand›r›lm›fl potansiyeller (DSEP) ve paraspinal haritalama (PH) gibi elektrodiagnostik teknikler LSS tan›s›nda duyarl›l›k ve özgüllü¤ü artt›rmak-tad›r. DSEP,...

show abstract

Section: Im Ma Ag Gi In Ng Gmentioning

confidence: 70%

Section: Im Ma Ag Gi In Ng Gmentioning

confidence: 99%

Electrodiagnosis in Lumbar Spinal Stenosis: A Review

Kishner¹,

Gündüz²,

Gupta³

et al. 2010

tftr

View full text Add to dashboard Cite

show abstract

“…Several authors have investigated the sensitivity of MEP in LSS or lumbosacral cord lesions and reported that the rate of abnormal MEP was increased after exercise [3,6,9,15,16]. Baramki et al [6] reported that MEPLT was significantly prolonged after walking a certain distance and concluded that exercise significantly increased the sensitivity of MEP in detecting roots under functional compression in LSS.…”

Section: Discussionmentioning

confidence: 99%

Clinical value of motor evoked potentials with transcranial magnetic stimulation in the assessment of lumbar spinal stenosis

Liu

Konno

Miyamoto

et al. 2008

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

The objective of this study was to evaluate the clinical usefulness of assessing motor evoked potentials (MEP) in lumbar spinal stenosis (LSS). Twenty-three LSS patients were enrolled. The preoperative data of MEP latency (MEPLT), clinical symptoms, Japanese Orthopaedic Association (JOA) scores for low back pain, visual analogue scale (VAS) for back pain, leg pain and numbness, walking distance and the minimal cross-sectional area (mCSA) of the dural sac were evaluated. The mean MEPLT was 42.1±2.8 ms. Fourteen patients had bilateral leg symptoms. The mean walking distance and mCSA were 302.1±302.8 m and 0.4±0.2 cm 2 , respectively. The mean JOA score and VAS scores for back pain, leg pain and numbness were 15.9±4.8, 6.0±2.9, 7.7±1.9 and 7.3±3.0, respectively. MEPLT was related to the walking distance, limb symptoms and the VAS for numbness. MEPLT was significantly delayed in patients who showed a walking distance less than 500 m. MEP is useful in LSS assessment. It can reflect the subjective severity of motor disturbance and predict the neurological deficit prior to appearance.Résumé L'objectif de cette étude est d'évaluer l'utilité des potentiels évoqués majeurs dans les canaux lombaires étroits. Méthode: 23 patients présentant un canal lombaire étroit (12 hommes et 11 femmes) ont été évalués. L'âge moyen était de 67,9±8,5 années. L'évaluation des potentiels évoqués moteurs pré-op ainsi que la symptomatologie, le score JOA, le score douleur ainsi que la douleur des deux membres inférieurs, la distance de marche avec claudication intermittente NIC et la surface de la section du sac dural ont été évalués, la largeur du sac dural MCSA étant évalué par IRM. Résultats: le temps de latence des potentiels évoqués moteurs était de 42,1±2,8 ms avec une symptomatologie moyenne ayant évolué pendant 31,5±31,8 mois. 12 patients présentaient un spondylolisthésis dégénératif associé. 14 patients avaient des signes bilatéraux et 9 unilatéraux. La claudication intermittente moyenne était de 302,1±302,8 mètres et la surface de section moyenne du cul-de-sac de 0,4±0,2 cm 2 . Le score moyen JOA, le score douleur VAS, les douleurs des membres inférieurs étaient respectivement de 15,9±4,8, 6±2,9, 7,7±1,9 et 7,3±3,0, avec un seul disque lésé dans 15 cas, deux dans 7 cas et trois dans un cas. Le temps moyen d'intermittence des potentiels évoqués rapporté au périmètre de marche à la symptomatologie douloureuse des membres inférieurs, au score JOA au nombre de disques, à la durée moyenne de la symptomatologie, au score douleur et au temps de latence des potentiels évoqués était significativement plus important chez les patients qui avaient un périmètre de marche inférieur à 500 mètres. En conclusion, les potentiels évoqués moteur sont utiles pour l'évaluation des canaux lombaires étroits et sont le reflet exact de la sévérité des lésions motrices. Ils permettent de prédire le déficit neurologique avant que celui-ci n'apparaisse.

show abstract

“…Dynamic electrophysiological examination in patients with lumbar spinal stenosis This paper by Adamova [1] reports a negative result, dynamic studies are not of value, although they demonstrate changes, such changes can be present in patients without claudication. Spinal stenosis, especially in the mild diabetic patient is a difficult diagnosis, and it is a shame that these examinations do not help.…”

Section: Spinal Stenosismentioning

confidence: 99%

The Michel Benoist and Robert Mulholland yearly European Spine Journal review

Mulholland¹

2006

Eur Spine J

View full text Add to dashboard Cite

Dynamic electrophysiological examination in patients with lumbar spinal stenosis: Is it useful in clinical practice?

Cited by 29 publications

References 17 publications

Electrodiagnosis in Lumbar Spinal Stenosis: A Review

Electrodiagnosis in Lumbar Spinal Stenosis: A Review

Clinical value of motor evoked potentials with transcranial magnetic stimulation in the assessment of lumbar spinal stenosis

The Michel Benoist and Robert Mulholland yearly European Spine Journal review

Contact Info

Product

Resources

About