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Discordance Between Anatomical Nerve Root Compression and Functional Radiculopathy in Patients with Lumbosacral
Yunjin Nam1, Jae Hyuk Yang2, Dong-Gune Chang3
1Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul 08308, Republic of Korea.
Journal of Clinical Medicine
|May 27, 2026
Summary
Lumbosacral transitional vertebrae (LSTV) often cause discrepancies between MRI-detected nerve root compression and EMG-confirmed radiculopathy. Complete transitional morphology significantly increases this anatomical-functional discordance.
Area of Science:
- Spinal anatomy and biomechanics
- Diagnostic imaging and electrophysiology
- Neurology and orthopedics
Background:
- Lumbosacral transitional vertebrae (LSTV) alter spinal anatomy and biomechanics, potentially complicating nerve root pathology localization.
- The relationship between MRI-identified nerve root compression and EMG-identified radiculopathy in LSTV patients is not well-defined.
Purpose of the Study:
- To evaluate the concordance between MRI-defined nerve root compression and EMG-defined radiculopathy in patients with LSTV.
- To investigate how transitional vertebral morphology influences the concordance between anatomical and electrophysiological findings.
Main Methods:
- Retrospective analysis of patients with LSTV undergoing MRI and needle EMG for lumbosacral radiculopathy.
- Classification of transitional vertebrae as lumbarization or sacralization (complete/partial).
- Assessment of concordance between MRI-defined compression and EMG-defined radiculopathy levels.
Main Results:
- A high discordance rate (72.4%) was observed between MRI and EMG findings in the cohort.
- Concordance was significantly lower in patients with complete transitional vertebrae compared to partial transitions.
- Twenty-nine patients were included in the analysis.
Conclusions:
- Patients with LSTV exhibit a high rate of anatomical-functional discordance between MRI and EMG.
- Complete transitional morphology is linked to increased discordance, indicating altered functional nerve root pathology expression.
- MRI and EMG may offer complementary diagnostic information in LSTV patients.
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