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

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 radicul...

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Published inMuscle & nerve Vol. 42; no. 2; pp. 276 - 282
Main Authors Cho, S. Charles, Ferrante, Mark A., Levin, Kerry H., Harmon, Robert L., So, Yuen T.
Format Journal Article
LanguageEnglish
Published Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.08.2010
Wiley Subscription Services, Inc
Subjects
Clinical Trials as Topic
Electrodiagnosis
electrophysiology
herniated disk
Humans
low back pain
lumbosacral radiculitis
lumbosacral radiculopathy
Lumbosacral Region - physiopathology
Neurologic Examination
Radiculopathy - diagnosis
Radiculopathy - physiopathology
root compression
sciatica
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Summary: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. Muscle Nerve 42:276–282, 2010
Bibliography:ark:/67375/WNG-PF5LF3MW-4
ArticleID:MUS21759
This report is provided as an educational service of the AANEM. It is based on an assessment of the current scientific and clinical literature. It is not intended to include all possible methods of care for a particular clinical problem, or all legitimate criteria for choosing to use a specific procedure. Neither is it intended to exclude any reasonable alternative methodologies. This statement is not intended to address all possible uses of, or issues regarding, the evaluation of lumbosacral radiculopathy, and in no way reflects upon the usefulness of electrodiagnostic studies in those areas not addressed. The AANEM recognizes that specific patient care decisions are the prerogative of the patient and his/her physician and are based on all of the circumstances involved. These guidelines are not a substitute for the experience and judgment of a physician. This review was not written with the intent that it be used as a basis for reimbursement decisions. This report was developed by committees of the AANEM. It did not undergo additional peer review by Muscle & Nerve.
istex:A12005A74BF75E6DEDB73A6F6F918EC2828CAECE
Muscle & Nerve
This report is provided as an educational service of the AANEM. It is based on an assessment of the current scientific and clinical literature. It is not intended to include all possible methods of care for a particular clinical problem, or all legitimate criteria for choosing to use a specific procedure. Neither is it intended to exclude any reasonable alternative methodologies. This statement is not intended to address all possible uses of, or issues regarding, the evaluation of lumbosacral radiculopathy, and in no way reflects upon the usefulness of electrodiagnostic studies in those areas not addressed. The AANEM recognizes that specific patient care decisions are the prerogative of the patient and his/her physician and are based on all of the circumstances involved. These guidelines are not a substitute for the experience and judgment of a physician. This review was not written with the intent that it be used as a basis for reimbursement decisions. This report was developed by committees of the AANEM. It did not undergo additional peer review by
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SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:0148-639X
1097-4598
DOI:10.1002/mus.21759