Electromyography and magnetic resonance imaging in the evaluation of radiculopathy

Nardin, Rachel; Patel, M. D.; Gudas, Thomas F.; Rutkove, Seward B.; Raynor, Elizabeth M.

doi:10.1002/(sici)1097-4598(199902)22:2<151::aid-mus2>3.0.co;2-b

Cited by 152 publications

(86 citation statements)

References 20 publications

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“…Total agreement between EDX and MRI studies was 59.6 % similar to previous studies (60 %) [19], although the agreement between them in relation to the clinical findings was 49 %. MRI and EDX presented similar agreement with clinical findings in the ''definite'' group while agreement of MRI with clinical findings was higher in other two groups.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies of patients with clinically suspected radiculopathy, the sensitivity of electromyography (EMG) was reported to range from 49 to 86 % [19][20][21][22][23] based upon history and physical examination which is similar to the figure of 54 % (95 % confidence interval: 0.44-0.64) in the present study. Data on agreement of EDX and MRI with clinical findings in radiculopathy are conflicting.…”

Section: Discussionmentioning

confidence: 99%

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A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

2014

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Purpose The aim of this study was to evaluate the agreement of magnetic resonance imaging and electrodiagnostic studies by comparing their findings in patients with clinically suspected radiculopathy. The agreements between these two procedures and clinical findings were also examined. Methods In a 2-year cross-sectional study, a total of 114 patients with clinically suspected cervical or lumbosacral radiculopathy were included. Results The total agreements between clinical with MRI and EDX findings were 72 and 52 %, respectively while their agreements were similar in group definite (89 vs. 82 %). The agreement between EDX and MRI was 59.6 in total and 49 % with respect to clinical findings. Conclusion This study further supports that these two methods are complementary in general. It is reasonable to add EDX when there is discrepancy between MRI and clinical findings or when MRI neurologic findings are not visible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

2014

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“…More advanced disease may demonstrate significantly decreased nerve conduction, with axonal loss and evidence of demyelination in a multi-radicular pattern [16][17][18][19] . treatment Before any treatment proposal, it is important to know the natural history of the disease.…”

Section: Radiological Findingsmentioning

confidence: 99%

Degenerative lumbar stenosis: update

Joaquim

Sansur

Hamilton

et al. 2009

Arq. Neuro-Psiquiatr.

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-We present a literature review of the diagnosis and treatment of acquired lumbar spinal stenosis (LS), with a brief description of new surgical techniques. LS is the most common cause of spinal surgery in individuals older than 65 years of age. Neurogenic claudication and radiculopathy result from compression of the cauda equina and lumbosacral nerve roots by degenerated spinal elements. Surgical decompression is a well established treatment for patients with refractory, or moderate to severe clinical symptoms. However, the variety of surgical options is vast. New techniques have been developed with the goal of increasing long term functional outcomes. In this article we review lumbar decompression and fusion as treatment options for LS but also present other recent developments. Prospective long term studies are necessary to know which procedures would result in optimal patient outcome.Key WordS: acquired lumbar stenosis, surgical treatment, new techniques, fusion. estenose lombar degenerativa: atualização resumo -Apresentamos uma revisão de literatura do diagnóstico e tratamento da estenose lombar (eL) adquirida, enfatizando as novas técnicas de manejo cirúrgico. A eL é a causa mais comum de cirurgia na coluna de pacientes com mais de 65 anos de idade. Claudicação neurogênica e radiculopatias são sintomas resultantes da compressão das raízes lombossacrais pelos elementos degenerados. A descompressão cirúrgica é um procedimento bem estabelecido para pacientes com sintomas severos ou refratários ao tratamento clínico. Contudo, as opções cirúrgicas são amplas. Novas técnicas de fusão e artrodese são úteis para melhorar os resultados funcionais. Neste artigo, varias alternativas cirúrgicas são apresentadas, incluindo as novas tecnologias na área. evidências científicas mais contundentes com seguimento longo são necessárias para a incorporação destas práticas na atividade médica de rotina.PALAvrAS-CHAve: estenose lombar adquirida, tratamento cirúrgico, novas técnicas, fusão.

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“…In fact, one study found EMG to have a sensitivity of 72% and a specificity of 85% in neurologically abnormal patients (41). Further research has shown abnormal EMGs in 35% to 64% of patients with radicular leg pain, and in 51% to 86% of those with abnormal neurologic examinations (42). The most common pattern of EMG findings in LSS appears to be multiple, bilateral lumbosacral radiculopathies, occurring with the following frequencies: L5 (48%), S1 (30%), L4 (17%), L3 (5%), S2 (4%), and L2 (3%) (43).…”

Section: N Ne Ee Ed DL Le E E Em Mg Gmentioning

confidence: 99%

Electrodiagnosis in Lumbar Spinal Stenosis: A Review

Kishner¹,

Gündüz²,

Gupta³

et al. 2010

tftr

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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,...

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Electromyography and magnetic resonance imaging in the evaluation of radiculopathy

Cited by 152 publications

References 20 publications

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

Degenerative lumbar stenosis: update

Electrodiagnosis in Lumbar Spinal Stenosis: A Review

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