Utility of electrodiagnostic testing in evaluating patients with lumbosacral radiculopathy: An evidence-based review

Stanford University School of Medicine, Stanford, California, USA.
Muscle & Nerve (Impact Factor: 2.28). 08/2010; 42(2):276-82. DOI: 10.1002/mus.21759
Source: PubMed


This is an evidence-based review of electrodiagnostic (EDX) testing of patients with suspected lumbosacral radiculopathy to determine its utility in diagnosis and prognosis. Literature searches were performed to identify articles applying EDX techniques to patients with suspected lumbosacral radiculopathy. From the 355 articles initially discovered, 119 articles describing nerve conduction studies, electromyography (EMG), or evoked potentials in adequate detail were reviewed further. Fifty-three studies met inclusion criteria and were graded using predetermined criteria for classification of evidence for diagnostic studies. Two class II, 7 class III, and 34 class IV studies described the diagnostic use of EDX. One class II and three class III articles described H-reflexes with acceptable statistical significance for use in the diagnosis and confirmation of suspected S1 lumbosacral radiculopathy. Two class II and two class III studies demonstrated a range of sensitivities for use of muscle paraspinal mapping. Two class II studies demonstrated the utility of peripheral myotomal limb electromyography in radiculopathies.

Download full-text


Available from: Yuen So,
77 Reads
  • Source
    • "Most lumbosacral radiculopathies are caused by root compression resulting from intervertebral disc degeneration.1 Lumbosacral nerve root compromise is clinically diagnosed by pain in the lower back that radiates into the leg below the buttocks, and may be confirmed with radiologic and electrodiagnostic studies.2-4 Imaging methods such as magnetic resonance imaging demonstrate structural abnormalities from which neurologic sequelae may be inferred. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Electrodiagnostic studies can be used to confirm the diagnosis of lumbosacral radiculopathies, but more sensitive diagnostic methods are often needed to measure the ensuing motor neuronal loss and sympathetic failure. Twenty-six patients with lumbar radiculopathy and 30 controls were investigated using nerve conduction studies, motor unit number estimation (MUNE), testing of the sympathetic skin response (SSR), quantitative electromyography (QEMG), and magnetic resonance myelography (MRM). Using QEMG as the gold standard, the sensitivity and specificity of MUNE for the abductor hallucis longus muscle were 71.4% and 70%, respectively. While they were 75% and 68.8%, respectively, when used MRM as gold standard. The sensitivity and specificity of MUNE for the extensor digitorum brevis muscle were 100% and 84.1%, respectively, when the peroneal motor amplitude as the gold standard. The SSR latency was slightly longer in the patients than in the controls. MUNE is a simple and sensitive test for evaluating autonomic function and for diagnosing lumbosacral radiculopathy in patients. MUNE could be used routinely as a guide for the rehabilitation of patients with radiculopathies. SSR measurements may reveal subtle sympathetic abnormalities in patients with lumbosacral radiculopathy.
    Journal of Clinical Neurology 01/2014; 10(1):10-6. DOI:10.3988/jcn.2014.10.1.10 · 1.70 Impact Factor
  • Source
    • "The H-reflex is believed to be a CMAP (Compound Muscle Action Potential) arising from an electrical afferent activation of a monosynaptic reflex arc.[12] The H-reflex is a useful electrophysiological procedure for evaluating the nerve conduction through the entire length of the afferent and efferent pathways, especially at the proximal segment of the peripheral nerve, which is inaccessible by routine surface stimulating and recording techniques,[3] and also suitable for evaluation of the potential entrapment of the S1 nerve root,[456] hence, it is sensitive in detecting mild S1 radiculopathy.[7] In studying S1 radiculopathy, prolonged onset latency and/or absence of the H-reflex on the affected side are the most commonly used measures of the H-reflex.[8910] "
    [Show abstract] [Hide abstract]
    ABSTRACT: The H-reflex is a useful electrophysiological procedure for evaluating the status of the peripheral nervous system, especially at the proximal segment of the peripheral nerve. The purpose of this study is to investigate the relation between triceps surae H-reflex and M- response latencies and thigh length in normal population, in order to determine if there is any regression equation between them. After screening 75 volunteers by considering inclusion and exclusion criteria, 72 of them were selected to enroll into our study (34 men and 38 women with the mean age of 36.04 ± 7.7 years). In all of the subjects H-reflex and M-response latencies were recorded by standard electrophysiological techniques and thigh length was measured. Finally, our data was analyzed for its relations with respect to ages in both sexes by appropriate statistical and mathematical methods. Mean ± SD for H-reflex latency was 27.94 ± 1.6 ms. We found a significant correlation between H-reflex latency and M-latency (r = 0.28), no significant correlation was found between H-reflex latency and thigh length (r = -0.051). Finally based on our findings we introduce a new formula in this paper. We found a significant correlation among of M-response latency and other variables (H-reflex latency and thigh length). Despite this it was eliminated from our formula. The relationship between H-reflex latency and age was significant. Further studies are required to delineate the clinical usage and interpretation of the formula, which we found in this study.
    Journal of research in medical sciences 03/2013; 18(3):188-92. · 0.65 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: NiSi is a promising material for applications in Si microelectronics. A good understanding of its fundamental physical properties is however necessary in order to obtain the best use possible. We present here the resistivity, Hall effect and low temperature specific heat of high quality single crystals. The resistivity of NiSi follows a classical metallic behaviour with a room temperature resistivity of similar to 10 mu Omega cm. The Hall coefficient at 300 K is about -1.0 x 10(-10) m(3) C-1; it changes sign at around 40 K and becomes positive: +0.5 x 10(-10) m(3) C-1 at 4.2 K. The specific heat shows a classical metallic behaviour, i.e. it follows a gamma T + beta T-3 law with gamma = 1.73 ml mole(-1) K-2 and beta = 0.0317 ml mole(-1) K-4. It also exhibits at the lowest temperatures an anomaly likely to be of magnetic origin.
    Materials for Advanced Metallization, 1997. MAM '97 Abstracts Booklet., European Workshop; 02/1998
Show more