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

Dillingham, Timothy R.; Annaswamy, Thiru M.; Plastaras, Christopher T.

doi:10.1002/mus.27008

Cited by 8 publications

(4 citation statements)

References 100 publications

(137 reference statements)

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“…The diagnosis of radiculopathy was considered positive when pathological findings were observed in at least 2 muscles sharing a common nerve root but originating from different peripheral nerves, and/or when the 'H' reflex was positive with abolished or attenuated response for S1 root [21,47,48].…”

Section: Methodsmentioning

confidence: 99%

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Lumbosacral Radiculopathy in Patients with Clinical Suspicion of the Pathology

Montaner-Cuello,

Caudevilla-Polo,

Rodríguez-Mena

et al. 2024

Preprint

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(1) Background: The diagnosis of lumbosacral radiculopathy involves anamnesis, assessment of sensitivity and strength, diagnostic imaging—usually magnetic resonance imaging (MRI)—and electrodiagnostic testing (EDX), typically electromyography (EMG) and electroneurography (ENG). MRI evaluates the structures supporting the spinal cord, while EDX evaluates root functionality. The present study aimed to analyze the concordance of MRI and EDX findings in patients with clinically suspected radiculopathy. Additionally, we investigated the comparison between these two reference tests and various clinical variables and questionnaires. (2) Methods: We designed a prospective epidemiological study of consecutive cases with an observational, descriptive, cross-sectional, and double-blind nature following the STROBE guidelines, encompassing 142 patients with clinical suspicion of lumbosacral radiculopathy. (3) Results: Of the sample, 58.5% tested positive for radiculopathy using EDX as the reference test, while 45.8% tested positive using MRI. The comparison between MRI and EDX in the diagnosis of radiculopathy in patients with clinical suspicion was not significant; the overall agreement was 40.8%. Only the years with symptoms were comparatively significant between the positive and negative radiculopathy groups as determined by EDX. (4) Conclusion: The comparison between lumbar radiculopathy diagnoses in patients with clinically suspected pathology using MRI and EDX as diagnostic modalities did not yield statistically significant findings. MRI and EDX are complementary tests assessing different aspects in patients with suspected radiculopathy; degeneration of the structures supporting the spinal cord does not necessarily imply root dysfunction.

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Section: Methodsmentioning

confidence: 99%

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Lumbosacral Radiculopathy in Patients with Clinical Suspicion of the Pathology

Montaner-Cuello,

Caudevilla-Polo,

Rodríguez-Mena

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Clinical Suspicion of Lumbosacral Radiculopathy

Montaner-Cuello,

Caudevilla-Polo,

Rodríguez-Mena

et al. 2024

Diagnostics

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(1) Background: The diagnosis of lumbosacral radiculopathy involves anamnesis, an assessment of sensitivity and strength, diagnostic imaging—usually magnetic resonance imaging (MRI)—and electrodiagnostic testing (EDX), typically electromyography (EMG), and electroneurography (ENG). MRI evaluates the structures supporting the spinal cord, while EDX evaluates root functionality. The present study aimed to analyze the concordance of MRI and EDX findings in patients with clinically suspected radiculopathy. Additionally, we investigated the comparison between these two reference tests and various clinical variables and questionnaires. (2) Methods: We designed a prospective epidemiological study of consecutive cases with an observational, descriptive, cross-sectional, and double-blind nature following the STROBE guidelines, encompassing 142 patients with clinical suspicion of lumbosacral radiculopathy. (3) Results: Of the sample, 58.5% tested positive for radiculopathy using EDX as the reference test, while 45.8% tested positive using MRI. The comparison between MRI and EDX in the diagnosis of radiculopathy in patients with clinical suspicion was not significant; the overall agreement was 40.8%. Only the years with symptoms were comparatively significant between the positive and negative radiculopathy groups as determined by EDX. (4) Conclusion: The comparison between lumbar radiculopathy diagnoses in patients with clinically suspected pathology using MRI and EDX as diagnostic modalities did not yield statistically significant findings. MRI and EDX are complementary tests assessing different aspects in patients with suspected radiculopathy; degeneration of the structures supporting the spinal cord does not necessarily imply root dysfunction.

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“…In general, when performing EMG, a screening exam that includes preferably 2 muscles from each myotome should be performed. 27,28 As NCS are frequently normal, localization is typically performed using EMG. For example, when evaluating a suspected C8-level myeloradiculopathy, the NCS may be completely normal, or one may (sometimes) see reduction in ulnar and/or median CMAPs, as both are C8-supplied peripheral nerves.…”

Section: Identification Of Level Of Pathologymentioning

confidence: 99%

“…demonstrates commonly assessed muscles based on cervical root level and peripheral innervation. In general, when performing EMG, a screening exam that includes preferably 2 muscles from each myotome should be performed 27,28. As NCS are frequently normal, localization is typically performed using EMG.…”

Section: Edx Studies In Dcmmentioning

confidence: 99%

Electrodiagnostic Studies in Degenerative Cervical Myelopathy

Davenport

Jandzinski

Ahmed

et al. 2022

Clinical Spine Surgery: A Spine Publication

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The diagnosis of degenerative cervical myelopathy can generally be made with a thorough history, physical examination, and spinal imaging. Electrodiagnostic studies, consisting of nerve conduction studies and electromyography, are a useful adjunct when the clinical picture is inconsistent or there is concern for overlapping pathology. Electrodiagnostic studies may be particularly helpful in identifying cases of myeloradiculopathy, when there is combined nerve root and spinal cord injury, both with regards to prognosis and guiding surgical treatment. Electrodiagnostic studies are a useful adjunct for the spine surgeon and should be used when there are features atypical for degenerative cervical myelopathy or when there is suspicion for a concomitant disease process.

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

Cited by 8 publications

References 100 publications

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Lumbosacral Radiculopathy in Patients with Clinical Suspicion of the Pathology

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Lumbosacral Radiculopathy in Patients with Clinical Suspicion of the Pathology

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Clinical Suspicion of Lumbosacral Radiculopathy

Electrodiagnostic Studies in Degenerative Cervical Myelopathy

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