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Routine electrodiagnosis and a multiparameter technique in lumbosacral radiculopathies
M A Fisher1, R Bajwa, K N Somashekar
1Hines VAH, Hines, IL 60141, USA. morris.fisher@med.va.gov
Objective:
This study compares Routine nerve conductions studies (NCS)/needle electromyography (nEMG) with a multiparameter recording method (NC-stat; NeuroMetrix Inc., Waltham, MA, USA) in patients with lumbosacral radiculopathies (LSR).
Methods:
Charts from 34 consecutive patients with a clinical history and/or examination consistent with an LSR were retrospectively reviewed. All underwent both Routine NCS/nEMG studies and NC-stat EDX. NC-stat testing included peroneal and posterior tibial nerve distal motor latencies and amplitudes and F-wave analysis. Twenty-eight patients had magnetic resonance imaging of the lumbosacral spine, and two had post-myelogram computerized tomography scan.
Results:
In the 24 patients with abnormal routine NCS/nEMG, NC-stat EDX was abnormal in 22. Raw agreement values between specific abnormal Routine and NC-stat EDX parameters ranged from 065 to 0.76. NC-stat amplitude and F-wave data provide reasonable electrodiagnostic 'rule in, rule out' information for LSR. Routine and NC-stat EDX had comparable positive and negative likelihood ratios with radiographic findings based on blinded neuroradiological evaluation. This included good 'stand alone' values for NC-stat F-wave and compound muscle action potential (CMAP) amplitude abnormalities in patients with spinal stenosis.
Conclusions:
This report supports the value of multiparameter clinical neurophysiological evaluations in patients with LSR including CMAPs and F-waves.
