[Comparison of clinical examination, electromyography, myelography, computerized tomography and surgical findings in...

The authors report 152 cases of patients with suspected herniated lumbar disk, operated on by traditional surgical approach. Thirteen of 152 patients underwent exploratory surgery at two vertebral spaces as a result of their neuroradiological examinations. All patients were examined clinically before of instrumental devices. CT-scan was performed on 113 patients, 62 underwent myelography and 36 electromyography. The authors verified reliability of clinical and instrumental devices on the basis of surgical results. Clinical examination was reliable in 83% of cases, electromyography in 78%, myelography in 83% and CT-scan in 87%. The percentage of false positive was 11% for the clinical examination, 9% for CT-scan, 8% for myelography and 11% for electromyography. The percentage of false negative was 6% for the clinical examination, 4% for CT-scan, 9% for myelography, and 11% for electromyography. The authors conclude that the CT-scan is the most reliable method of examination. This is even truer when dealing with extreme lateral disk herniation.