Electrodiagnostic Evaluation of Lumbar Spine Problems

Press, Joel M.; Wiesner, Steven L.; MacLean, Ian C.

doi:10.1016/s1047-9651(18)30729-0

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…1,2,4,5,[7][8][9][12][13][14] It is thought that early on, within 7-10 days, SA begins in the PSM, and that later, within 3-6 weeks, the distal muscles become involved and show abnormal SA. 1,2,5,6,8 Likewise, reinnervation is reported to have a proximal to distal time course, with PSM reinnervating first (6-9 weeks), then proximal muscles (2-5 months), and finally distal muscles (3-7 months).…”

mentioning

confidence: 99%

Cervical paraspinal muscle abnormalities and symptom duration: A multivariate analysis

1998

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mentioning

confidence: 99%

Cervical paraspinal muscle abnormalities and symptom duration: A multivariate analysis

1998

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“…The relationship between PSM spontaneous activity and symptom duration has been widely cited in the literature. 1,2,7,8,[10][11][12]15,16,17 Until recently, however, no published study provided a rigorous analysis upon which to base this contention. 6 The results of this prospective, multicenter study do not support the premise of a temporal course of denervation, as evidenced by the presence of abnormal spontaneous activity on EMG, in electrodiagnostically confirmed CRs.…”

Section: Discussionmentioning

confidence: 99%

“…The proposition that the paraspinal muscles (PSM) show spontaneous activity (fibrillations and positive sharp waves) by needle electromyography (EMG) early or within the first month of symptom duration is a prominent and widely accepted belief in the electrodiagnostic literature. 1,2,5,8,[9][10][11]15,16,17 Many authors describe the temporal course of events in a radiculopathy. It is believed that, within 7 to 10 days, spontaneous activity begins in the PSM and that later, within 3 to 6 weeks, the distal muscles become involved and show spontaneous activity.…”

Section: Accepted 1 June 1999mentioning

confidence: 99%

“…1,2,7,8,10 Simi-larly, reinnervation is reported to have a proximal to distal time course, with PSM reinnervating first and distal muscles reinnervating last. 2,7,15,16 Reinnervation is thought to occur after about 6 to 9 weeks for PSM, 2 to 5 months for proximal muscles, and 3 to 7 months for distal muscles. 7 Despite its general acceptance among clinicians, only one published study has provided a quantitative analysis of the relationship between muscle spontaneous activity in cervical radiculopathies (CRs) and symptom duration.…”

Section: Accepted 1 June 1999mentioning

confidence: 99%

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Cervical radiculopathies: Relationship between symptom duration and spontaneous EMG activity

Pezzin¹,

Dillingham²,

Lauder³

et al. 1999

Muscle Nerve

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The purpose of this multicenter study was to prospectively examine whether denervation in paraspinal muscles (PSM) and in other major proximal and distal muscles is related to symptom duration in cervical radiculopathies (CRs). Information was collected on 93 electrodiagnostically confirmed CRs using standardized history, physical examination, and electromyographic (EMG) screens. Multivariate, maximum‐likelihood estimates showed no evidence of correlation between PSM spontaneous activity and symptom duration. Symptom duration was also nonsignificant in eight of the remaining nine upper limb muscles analyzed. We conclude that the probability of spontaneous activity is not related to symptom duration. Clinicians, therefore, should refrain from interpreting electrodiagnostic findings based upon duration of symptoms. © 1999 John Wiley & Sons, Inc. Muscle Nerve 22: 1412–1418, 1999

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Evaluating Lumbar Radiculopathy

Talmage¹,

Eskay-Auerbach²,

Blaisdell³

2014

AMA Guides® Newsletter

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For workers’ compensation, most requests for a permanent impairment rating of low back injuries involve the diagnostic labels of nonspecific chronic low back pain or intervertebral disk herniation. Use of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to choose the right diagnosis and class for these injuries is the first step and involves correctly choosing between “nonverifiable radicular complaints” and “residual radiculopathy.” Evaluators must be able to distinguish persisting radiculopathy, as defined in the sixth edition, from resolved radiculopathy and from nonverifiable radicular complaints and to support findings with objective clinical evidence. Clinical evidence of chronic radiculopathy might include motor weakness, muscle atrophy, impaired sharp–dull discrimination, and/or abnormal electrodiagnostic tests, provided the findings are persistent and there are reflex abnormalities. When considering radiculopathy in the appropriate spine grid of the AMA Guides, Sixth Edition, the evaluator must distinguish radicular (limb) symptoms that are continuous, intermittent, or completely resolved. Positive electromyography (EMG) studies for acute radiculopathy are a sufficient objective finding to state the person has radiculopathy on the date of the test; individuals with positive needle EMG do have persisting radiculopathy at maximum medical improvement, but this does not mean that radiculopathy must persist despite time and treatment.

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Electrodiagnostic Evaluation of Lumbar Spine Problems

Cited by 4 publications

References 28 publications

Cervical paraspinal muscle abnormalities and symptom duration: A multivariate analysis

Cervical paraspinal muscle abnormalities and symptom duration: A multivariate analysis

Cervical radiculopathies: Relationship between symptom duration and spontaneous EMG activity

Evaluating Lumbar Radiculopathy

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