Abstract
Tong HC. Incremental ability of needle electromyography to detect radiculopathy in
patients with radiating low back pain using different diagnostic criteria.
Objective
To determine the incremental ability of different needle electromyography diagnostic
criteria to detect lumbar radiculopathy.
Design
Blinded cross-sectional study.
Setting
University hospital.
Participants
Subjects aged 55 to 80 years with radiating low back pain (n=48; mean age ± SD, 67.9±7.3y)
and who were asymptomatic (n=30; mean age ± SD, 65.4±8y).
Interventions
Electrodiagnostic evaluation by a blinded electromyographer. A monopolar needle was
used to evaluate 5 leg muscles and the lumbar paraspinal muscles.
Main Outcome Measures
Presence or absence of radiculopathy using different electrodiagnostic criteria.
Results
When only positive sharp waves or fibrillations were considered, and at least 2 muscles
innervated by the same root level and different peripheral nerves were counted as
abnormal, 27.1% (13/48) of participants had positive results for radiculopathy. When
at least 30% motor unit action potential changes in the limb muscles were also considered,
participants with positive results increased to 45.8% (22/48), which was significant
when compared with the first criterion (P=.002). When the mini-paraspinal mapping (MiniPM) test as well as at least a 30% motor
unit cutoff was used, participants with positive results increased to 50% (24/48),
which was significant when compared with the first criterion (P=.001).
Conclusions
In addition to the presence of positive sharp waves or fibrillations, considering
greater than or equal to 30% motor unit action unit potential changes as well as the
MiniPM score maintains good specificity and improves the ability of the needle electromyography
study to detect lumbar radiculopathy in subjects with radiating low back pain.
Key Words
List of Abbreviations:
GLM (general linear model), MiniPM (mini-paraspinal mapping), MRI (magnetic resonance imaging), MUAP (motor unit action potential), PorFib (positive sharp waves or fibrillation potentials)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- AAEM minimonograph 32: the electrodiagnostic examination in patients with radiculopathies.Muscle Nerve. 1998; 21: 1612-1631
- Electrodiagnostic medicine.Hanley & Belfus, Philadelphia2002
- The sensitivity and specificity of electrodiagnostic testing for the clinical syndrome of lumbar spinal stenosis.Spine. 2005; 30: 2667-2676
- Specificity of needle electromyography for lumbar radiculopathy and plexopathy in 55- to 79-year-old asymptomatic subjects.Am J Phys Med Rehabil. 2006; 85 (quiz 913-5, 934): 908-912
- A technique for needle localization in paraspinal muscles with cadaveric confirmation.Muscle Nerve. 1991; 14: 521-526
- Electromyographic and magnetic resonance imaging to predict lumbar stenosis, low-back pain, and no back symptoms.J Bone Joint Surg Am. 2007; 89: 358-366
- Paraspinal mapping.Spine. 1995; 20: 715-721
- Clinical experience with paraspinal mapping.Arch Phys Med Rehabil. 1997; 78: 1185-1190
- Identifying lumbosacral radiculopathies: an optimal electromyographic screen.Am J Phys Med Rehabil. 2000; 79: 496-503
- Lumbar spinal stenosis.Ann Intern Med. 1985; 103: 271-275
- Lumbar spinal stenosis syndrome.Clin Orthop. 1989; 246: 70-80
- Electromyography in the diagnosis of lumbar spinal stenosis.Electromyogr Clin Neurophysiol. 1981; 21: 55-66
- Neurophysiologic investigation of patients with spinal stenosis.Spine. 1987; 12: 483-487
- Lumbar stenosis.Clin Orthop Relat Res. 1976; : 68-71
Article info
Publication history
Published online: April 01, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author or on any organization with which the author is associated.
Reprints are not available from the author.
In-press corrected proof published online on Apr 1, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
