Cervical radiculopathies: Relationship between symptom duration and spontaneous EMG activity

Pezzin, Liliana E.; Dillingham, Timothy R.; Lauder, Tamara D.; Andary, Michael; Stephens, R.; Shannon, Steven

doi:10.1002/(sici)1097-4598(199910)22:10<1412::aid-mus11>3.0.co;2-u

Cited by 24 publications

(7 citation statements)

References 11 publications

(21 reference statements)

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“…In another study, the duration of symptoms and abnormalities in paraspinal, proximal and distal muscles were compared in 139 patients with lumbosacral radiculopathy, and again there was no significant relationship [9]. The duration of symptoms and spontaneous EMG activities were evaluated in 93 cervical radiculopathy patients who were diagnosed with electrodiagnostic methods and no significant relationship was found [10].…”

Section: Discussionmentioning

confidence: 98%

Comparison of clinical and electrophysiological findings in patients with suspected radiculopathies

İnal

Eser

Aktekin

et al. 2013

BMR

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Cervical and lumbar roots may be irritated or compressed due to the pathological conditions such as disc herniations, degenerative foraminal stenosis, trauma and tumors. Electrophysiologic tests are frequently used in conjunction with imaging modalities for evaluation of low back and neck pain radiating to extremities, primarily for the purpose of establishing the presence or absence of a radiculopathy. In this study, we aimed to evalulate the relationship between clinic and electroneuromyographic (ENMG) findings in patients with suspected radiculopathies. Forty one patients with radicular complaints in the upper extremities and 51 patients with radicular complaints in the lower extremities were included in this study. McNemar test and Kappa coefficients between the two methods were applied to each group of patients, in order to test the significance of the difference between the two diagnostic procedures' ability on finding out the pathology. The McNemar test identified a significant difference between the two diagnostic approaches both for cervical and lumbar radiculopathies (p<0.001). The Kappa coefficients between the two methods were determined as 0.08 and 0.07, respectively. This means, efficacy of anamnesis and neurological examination for the prediction of electrodiagnostic tests was found to be limited. Normal neurological examination results in a patient with suspected radiculopathy can not eliminate abnormal electrodiagnostic test results; likewise, abnormal findings in the neurological examination would not mean finding pathologies in the electrodiagnostic tests. For more accurate approach to a patient, neurological examination and electrodiagnostic tests must be used and interpreted together.

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Section: Discussionmentioning

confidence: 98%

Comparison of clinical and electrophysiological findings in patients with suspected radiculopathies

İnal

Eser

Aktekin

et al. 2013

BMR

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“…These studies incorporated patients with a broad range of symptom durations. The findings from these investigations underscore the fact that the pathophysiological processes involved with cervical and lumbosacral radiculopathies are complex and do not follow a predictable time course of denervation and reinnervation 37‐40 . Needle EMG abnormalities in cervical and lumbosacral radiculopathies that result from these pathophysiological processes cannot be predicted by this overly simplistic, symptom‐duration explanation.…”

Section: Symptom Duration Is Not Related To the Probability Of Fibrilmentioning

confidence: 83%

“…This paradigm was challenged by a series of investigations 37‐40 . For both EDX‐confirmed lumbosacral and cervical radiculopathies, symptom duration had no significant relationship to the probability of finding spontaneous activity in either paraspinal muscles or limb muscles.…”

Section: Symptom Duration Is Not Related To the Probability Of Fibrilmentioning

confidence: 99%

Evaluation of persons with suspected lumbosacral and cervical radiculopathy: Electrodiagnostic assessment and implications for treatment and outcomes (Part II)

2020

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The electrodiagnostic (EDX) examination with needle electromyography (EMG) is the most important means of testing for radiculopathy. This test has modest sensitivity but high specificity and complements imaging of the spine. In this second of a two-part review, the implications of electrodiagnostic findings for diagnosis and clinical management of persons with radiculopathy are reviewed. An EMG confirmed lumbosacral radiculopathy is associated with better clinical outcomes for persons undergoing aggressive conservative management. A positive EMG test portends a better clinical response to epidural corticosteroid injections. If a person undergoes spine surgery, a positive preoperative EMG for radiculopathy is also associated with better outcomes.

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“…Patients with ≥2 months duration of symptoms were chosen in this study to observe denervation potentials and reinnervation. Despite this classic data, Dillingham et al (14) suggested that cervical and lumbosacral radiculopathy showed no evidence of correlation between spontaneous activity in the paraspinal and in other major proximal, or distal muscles and symptom duration (15). However, we aimed to observe the denervation potentials and re-innervation findings in this study.…”

Section: Discussionmentioning

confidence: 97%

Correlation of Electromyography and Magnetic Resonance Imaging Findings in the Diagnosis of Suspected Radiculopathy

Arslan¹,

Yaşar²,

Zorlu³

2016

tnd

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Objective: Patients with pain or numbness without motor deficits are the most common group referred to electrophysiology laboratories as suspected radiculopathy. We wanted to investigate whether electromyography (EMG) was useful for this group in the diagnosis or therapy of radiculopathy. Our aim was to investigate the correlation and classification of EMG and magnetic resonance imaging (MRI) findings in the diagnosis of suspected radiculopathy. Materials and Methods:We included 74 patients with a ≥2-month history of numbness and pain in the neck and back that radiated into the arm or leg. Patients with diabetes mellitus, previous disc or spine operation, polyneuropathy, spinal cord diseases (tumor, infection or syrinxs), motor deficits, and abnormal nerve conduction studies were excluded. Results:The mean age of the patients was 51.58±11.53 years. In total, 41 (55.4%) patients were women and 33 (44.6%) were men; 48.8% (n=36) showed cervical radiculopathy and 51.2% (n=38) exhibited lumbosacral radiculopathy. The most common MRI finding was protrusion (37.8%), and the most common EMG finding was re-innervation (59.5%). The correlation of MRI and EMG findings was significant in lumbar radiculopathy (p=0.007), but not in the cervical radiculopathy results (p=0.976).Conclusion: EMG and MRI findings were compatible for lumbar radiculopathy, but not for cervical radiculopathy in mild to moderate grades. Keywords: Suspected radiculopathy, electromyography, magnetic resonance imagingAmaç: Elektrofizyoloji laboratuvarına şüpheli radikülopati tanısıyla gönderilen hastaların çoğu motor defisit olmadan ağrı ve uyuşukluk şikayetiyle başvuran gruptur. Biz elektromiyografinin (EMG) bu grup hastalarda radikülopatinin tanı ve tedavisinde faydalı olup olmadığını araştırmak istedik. Amacımız şüpheli radikülopati tanısında EMG ve manyetik rezonans görüntüleme (MRG) bulgularının sınıflandırılması ve korelasyonunun araştırılmasıdır. Gereç ve Yöntem:Çalışmaya en az 2 aydır boyunda ve belde başlayıp kola veya bacağa yayılan ağrı ve uyuşması olan 74 hasta dahil edildi. Diabetes mellitus, geçirilmiş disk veya omurga operasyonu, polinöropati, spinal kord hastalığı olanlar (tümör, enfeksiyon veya sirinks gibi) ile motor defisit ve anormal sinir iletim çalışmaları olan hastalar dışlandı. Bulgular:Hastaların yaş ortalaması 51,58±11,53 idi. Çalışmaya dahil edilen 41 (%55,4) hasta kadın, 33 (%44,6) hasta erkekti. Hastaların %48,8'inde (n=36) servikal radikülopati %51,2'sinde (n=38) lumbosakral radikülopati saptandı. En sık görülen MRG bulgusu protrüzyon (%37,8), en sık görülen EMG bulgusu re-innervasyondu (%59,5). EMG ve MRG bulgularının korelasyonu lomber radikülopatide istatistiksel olarak anlamlıydı (p=0,007), ancak servikal radikülopati olanlarda anlamlı değildi (p=0,976). Sonuç:Hafif ve orta evre radikülopatide MRG ve EMG sonuçları lomber radikülopati de uyumlu saptandı, ancak servikal radikülopatide uyumlu değildi.Anahtar Kelimeler: Şüpheli radikülopati, elektromiyografi, manyetik rezonans görüntüleme Sum mary Öz 55Original Article / Özg...

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Cervical radiculopathies: Relationship between symptom duration and spontaneous EMG activity

Cited by 24 publications

References 11 publications

Comparison of clinical and electrophysiological findings in patients with suspected radiculopathies

Comparison of clinical and electrophysiological findings in patients with suspected radiculopathies

Evaluation of persons with suspected lumbosacral and cervical radiculopathy: Electrodiagnostic assessment and implications for treatment and outcomes (Part II)

Correlation of Electromyography and Magnetic Resonance Imaging Findings in the Diagnosis of Suspected Radiculopathy

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