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At least 19 recordsLinked to original sources
PubMed1997

Cervical radiculopathy: pain, muscle weakness and sensory loss in patients with cervical radiculopathy treated with surgery, physiotherapy or cervical collar. A prospective, controlled study.

This prospective, randomised study compares the efficacy of surgery, physiotherapy and cervical collar with respect to pain, motor weakness and sensory loss in 81 patients with long-lasting cervical radiculopathy corresponding to a nerve root that was significantly compressed by spondylotic encroachment, with or without an additional bulging disk, as verified by MRI or CT-myelography. Pain intensity was registered on a visual analogue scale (VAS), muscle strength was measured by a hand-held dynamometer, Vigorometer and pinchometer. Sensory loss and paraesthesia were recorded. The measurements were performed before treatment (control 1), 4 months after the start of treatment (control 2) and after a further 12 months (control 3). A healthy control group was used for comparison and to test the reliability of the muscle-strength measurements. The study found that before start of treatment the groups were uniform with respect to pain, motor weakness and sensory loss. At control 2 the surgery group reported less pain, less sensory loss and had better muscle strength, measured as the ratio of the affected side to the non-affected side, compared to the two conservative treatment groups. After a further year (control 3), there were no differences in pain intensity, sensory loss or paraesthesia between the groups. An improvement in muscle strengths, measured as the ratio of the affected to the non-affected side, was seen in the surgery group compared to the physiotherapy group in wrist extension, elbow extension, shoulder abduction and internal rotation, but there were no differences in the ratios between the collar group and the other treatment groups. With respect to absolute muscle strength of the affected sides, there were no differences at control 1. At control 2, the surgery group performed some-what better than the two other groups but at control 3 there were no differences between the groups. We conclude that pain intensity, muscle weakness and sensory loss can be expected to improve within a few months after surgery, while slow improvement with conservative treatments and recurrent symptoms in the surgery group make the 1-year results about equal.

Adult↗
PubMed1998

Radiculopathy after laminoplasty of the cervical spine.

STUDY DESIGN: The risk factors of patients with and without radiculopathy after laminoplasty of the cervical spine were compared retrospectively. OBJECTIVES: To study the association between risk variables and postlaminoplastic radiculopathy to clarify the pathogenesis of radiculopathy and to devise preventive measures. SUMMARY OF BACKGROUND DATA: Radiculopathy after cervical laminoplasty on the expanded side has been attributed mainly to traumatic surgical techniques, whereas radiculopathy on the hinged side has been attributed to traction, tethering, or kinking of the nerve root that has resulted from posterior shift of the spinal cord from the preoperative position. There is still much divergence of opinion concerning the risk factors for the outbreak as well as the prevention. METHODS: Of 365 patients who had undergone laminoplasty, 20 patients (5.5%) developed postoperative radiculopathy. Using data from postoperative computed tomography scans and other sources, these patients were compared with 211 patients with no radiculopathy, who had undergone laminoplasty during the same period, to identify risk factors related to patient characteristics and surgical techniques. RESULTS: Of various risk factors studied, the narrowest level of the spinal canal, preoperative symptomatic severity, flatness of the spinal cord assessed by computed tomography myelography at C4-C5, cervical curvature, anterior protrusion of the superior articular process as assessed by computed tomography scan, laterality of the osteophytes, and ossification of the posterior longitudinal ligament could not significantly discriminate between patients with and without postoperative radiculopathy. The angle of lamina as measured by using computed tomography scans obtained after expansion in the patients with radiculopathy was greater than 68 degrees on the opened and hinged sides and was significantly greater than the angle in patients without radiculopathy (P < 0.05). The incidence of radiculopathy on both the opened and hinged sides was significantly higher in patients in whom the bony gutter had been cut on the lateral side of the medial aspect of the zygapophyseal joint. CONCLUSION: Any one of patients' characteristics could not be correlated with postoperative cervical radiculopathy in this study. To prevent postoperative radiculopathy, it may be important during surgery to place the bony gutter on the medial side of the zygapophyseal joint and to keep the slope of the opened lamina within 60 degrees.

Adult↗
PubMed2005

Are tender points associated with cervical radiculopathy?

OBJECTIVE: To determine if there is an association between cervical radiculopathy and tender spots in the neck and upper extremity on the side of radiculopathy. DESIGN: Prospective cross-sectional study. SETTING: Outpatient spine clinic within an academic institution. PARTICIPANTS: Convenience sample of 16 subjects with unilateral cervical radiculopathy. Twelve subjects had C7 radiculopathy and 4 had C6 or C8 radiculopathy. INTERVENTION: Bilateral pain-pressure threshold measurement (14 muscles) of the neck and upper extremity. MAIN OUTCOME MEASURE: Side-to-side difference in pain-pressure threshold. RESULTS: Differences in frequency of tender spots were found only in the deltoid and flexor carpi radialis. Overall, more tender spots were found on the side of radiculopathy (75 vs 34, P < .01). Among subjects with C7 radiculopathy, the number of tender spots in C7 innervated muscles was greater on the side of radiculopathy (23 vs 7, P < .02). In contrast, no significant difference in the number of tender spots between sides was found when only non-C7 innervated muscles (P > 0.1) were considered. CONCLUSIONS: Cervical radiculopathy was associated with increased tender spots on the side of radiculopathy, with predilection toward muscles innervated by the involved nerve root.

Adult↗
PubMed2003

Comparison of four tests of quadriceps strength in L3 or L4 radiculopathies.

STUDY DESIGN: This prospective cohort study evaluated four office tests of quadriceps strength in symptomatic adults with radiographic evidence of L3 or L4 nerve root compression. OBJECTIVE: The study observed the performance of each test for its ability to detect quadriceps weakness when compared to the asymptomatic side. To determine the potential influence of radicular pain on the performance of the four tests, a control group of patients over the age of 40 with clinical and radiographic L5 or S1 radiculopathies underwent identical testing of quadriceps strength. SUMMARY OF BACKGROUND DATA: The L3 and L4 nerve roots innervate the quadriceps; therefore, quadriceps weakness may be a consequence of L3 or L4 radiculopathies. There are no standardized or validated methods to evaluate quadriceps strength in the clinical office setting. This may lead to inconsistent detection by clinicians of quadriceps weakness in cases of L3 or L4 radiculopathy. METHODS: Thirty-three consecutive patients with L3 or L4 radiculopathies and 19 with L5 or S1 radiculopathies were studied. The four tests of quadriceps strength included: 1) single leg sit-to-stand test; 2) step-up test; 3) knee-flexed manual muscle testing; and 4) knee-extended manual muscle testing. Results from a second examiner repeating the four tests were used to calculate interrater reliability. RESULTS: In L3 and L4 radiculopathies, unilateral quadriceps weakness was detected by the single leg sit-to-stand test in 61%, by knee-flexed manual muscle testing in 42%, by step-up test in 27% and by knee-extended manual muscle testing in 9% of patients. The sit-to-stand test detected weakness in all but one case when weakness was detected by another test. All patients with L5 or S1 radiculopathies could perform the sit-to-stand test. Kappa coefficient was high for sit-to-stand test (0.85), step-up (0.83), and knee-flexed manual muscle testing (0.66), and low for knee-extended manual muscle testing (0.08). CONCLUSION: In L3 and L4 radiculopathies, unilateral quadriceps weakness was best detected by a single leg sit-to-stand test. Patients of similar age with radicular pain caused by L5 or S1 radiculopathies could perform this test. As the interrater reliability of the single leg sit-to-stand test is high, clinicians should consider utilizing this test for assessing quadriceps strength in cases of L3 and L4 radiculopathies.

Aged↗
PubMed1995

[Clinical study of cervical radiculopathy after laminoplasty for cervical myelopathy].

We have retrospectively determined the preoperative risk factors in cervical radiculopathy after laminoplasty for cervical myelopathy using preoperative neuroradiographical findings and electrophysiological studies. Of the 67 patients who underwent laminoplasty, 10 patients (14.9%) postoperatively showed cervical radioculopathy. The preoperative radiographical findings had included cervical lordosis, intraspinal cord centering, and anterior protrusion of the apex of the superior articular process. Needle electromyography, somatosensory evoked potentials (SEPs), sensory nerve action potentials (SNAP) were preoperatively examined in 42 cases. There was no relationship between the postoperative radiculopathy and the preoperative radiographical findings. Six (100%) of 6 cases preoperatively diagnosed as C5 radiculopathy (postganglionic type) with Erb-P 14 interpeak latency of dermatomal SEPs and SNAP, developed postoperative C5 radiculopathy. One (25%) of 4 cases preoperatively diagnosed as C6 radiculopathy developed postoperative C6 radiculopathy. No case preoperatively diagnosed as C7 or C8 radiculopathy developed postoperative radiculopathy. This study suggested that an important risk factor for postoperative radiculopathy was subclinical C5 radiculopathy (postganglionic type) that could be preoperatively evaluated using electrophysiological studies.

Adult↗
PubMed2006

Headache in patients with cervical radiculopathy: a prospective study with selective nerve root blocks in 275 patients.

Since many years we routinely use diagnostic selective nerve root blocks (SNRB) at our department when evaluating patients with cervical radiculopathy. Frequently patients who also presented with headache reported that the headache disappeared when the nerve root responsible for the radicular pain was blocked with local anaesthetics. Headache has been described as a companioning symptom related to cervical radiculopathy but has never before been evaluated with SNRB performed in the lower cervical spine. For this reason we added to our routine an evaluation of the response from the SNRB on headache in patients with cervical radiculopathy. The aim was to describe the frequency of headache in patients with cervical radiculopathy and its response to a selective nerve root block of the nerve root/roots responsible for the radiculopathy. Can nerve root compression in the lower cervical spine produce headache? In this consecutive series of 275 patients with cervical radiculopathy, 161 patients reported that they also suffered from daily or recurrent headache located most often unilaterally on the same side as the radiculopathy. All patients underwent a careful clinical examination by a neurosurgeon and a MRI of the cervical spine. The significantly compressed root/roots, according to the MRI, underwent SNRB with a local anaesthetic. The effect of the nerve root block on the radiculopathy and the headache was carefully noted and evaluated by a physiotherapist using visual analogue scales (VAS) before and after the SNRB. All patients with headache had tender points in the neck/shoulder region on the affected side. Patients with headache graded significantly more limitations in daily activities and higher pain intensity in the neck/shoulder/arm than patients without headache. After selective nerve root block, 59% of the patients with headache reported 50% or more reduction of headache and of these 69% reported total relief. A significant correlation was seen between reduced headache intensity and reduced pain in the neck, shoulder and arm. The result indicates that cervical root compression from degenerative disease in the lower cervical spine producing radiculopathy might also induce headache.

Adult↗
PubMed2006

Frequency and severity of carpal tunnel syndrome according to level of cervical radiculopathy: double crush syndrome?

OBJECTIVE: The double crush hypothesis (DC) proposes that a proximal lesion along an axon predisposes it to injury at a more distal site along its course through impaired axoplasmic flow. The frequency and severity of carpal tunnel syndrome (CTS) according to the level of cervical radiculopathy were investigated to evaluate the hypothesis of DC. METHODS: The frequency of CTS was investigated in 277 patients with C6, C7 or C8 radiculopathies and correlation between CTS and radiculopathy level was determined. We also investigated whether the degrees of abnormal sensory responses were more severe in C6, C7 radiculopathies and whether motor responses were more severe in C8 radiculopathy. RESULTS: Thirty-nine patients were diagnosed with CTS and concomitant cervical radiculopathy at the C6, 7, or C8 root levels. The frequency of coexisting CTS was not statistically different according to the level of radiculopathy. The electrophysiologic results revealed no significant correlation between median sensory parameters and C6, C7 cases, and no relationship was observed between median motor responses and C8 radiculopathy. CONCLUSIONS: The frequency and electrophysiologic data of CTS analyzed according to cervical radiculopathy level do not support a neurophysiological explanation. SIGNIFICANCE: Based on this study, the DC hypothesis could not be supported.

Axonal Transport↗
PubMed2007

Assessment of forearm pronation strength in C6 and C7 radiculopathies.

STUDY DESIGN: Consecutive case series of patients with C6 and C7 radiculopathies. OBJECTIVES: To explore the clinical utility and reliability of manual muscle testing of forearm pronation strength in C6 and C7 radiculopathies. SUMMARY OF BACKGROUND DATA: EMG evidence of denervation of the pronator teres was the most common finding in C6 radiculopathies, and frequently present in C7 radiculopathies. Clinical evaluation of the pronator teres through manual muscle testing of forearm pronation has never been explored; therefore, its clinical utility is unknown as compared with the muscle groups that are traditionally evaluated. METHODS: Fifty-five subjects with diagnostic imaging evidence of either C6 (n = 25) or C7 (n = 30) cervical root compression and clinical symptoms consistent with cervical radiculopathy were recruited for this study. These subjects underwent manual muscle testing of forearm pronation, wrist extension, elbow flexion, and elbow extension. The frequency of impaired strength was recorded and compared for C6 and C7 radiculopathies. A second examiner evaluated each subject, with his or her findings compared with the first examiner only for the determination of interrater reliability. RESULTS: In C6 radiculopathy subjects, forearm pronation weakness was present in 72%, was twice as common as wrist extension weakness, was present in all cases where elbow flexion or wrist extension weakness was noted, and was found in all but 2 subjects where elbow extension weakness was present. In C7 radiculopathy subjects, forearm pronation weakness accompanies elbow extension weakness in 23% of subjects and was the only weakness in 10% of subjects. Manual muscle testing demonstrated adequate interrater reliability. CONCLUSIONS: Forearm pronation weakness is the most frequent motor finding in C6 radiculopathies and may be noted is some cases of C7 nerve root compression.

Adult↗
PubMed2002

Electrophysiology of radiculopathies.

The anatomy, pathophysiology, and clinical evaluation of radiculopathies are discussed. Defining whether root injury is present and which roots are involved can be difficult but critical for patient management. In conjunction with clinical and radiological information, studies that establish physiological abnormalities of roots should be helpful and important. Clinical neurophysiological studies for radiculopathies are performed frequently but have yet to achieve a universally accepted role in the evaluation of these patients. Electrophysiological techniques for the evaluation of radiculopathies are reviewed. Needle electromyography is the best established of these procedures but has the disadvantage of requiring injury to motor fibers of both a certain degree and distribution. Nerve conduction studies may rarely be abnormal in radiculopathies but are needed to be certain other conditions that may produce similar symptoms and signs are not present. H reflexes and F waves probably have roles in the evaluation of radiculopathies but published reports about F waves in radiculopathies have been marred by inadequate methodology. There is evidence based on large series of patients that somatosensory evoked potentials can be helpful for evaluating patients with multilevel injury such as spinal stenosis, patients where electrophysiological studies may have their greatest clinical utility. Further work using either electrical stimulation with needles or magnetic stimulation of roots seems warranted. The demonstration of meaningful electrophysiological changes with activities that reproduce radicular symptoms may be a promising experimental approach. Available information does not necessarily answer critical questions about the role of electrophysiology in patients with radiculopathies. This cannot be done using analyses based on current ideas about evidence based medicine given the absence of a 'gold standard' for defining radiculopathies as well the absence of blinded studies. The available information provides strong arguments for further investigations evaluating different clinical neurophysiological techniques in the same patient, and for evaluating the value of these techniques by concentrating on their clinical import.

Electrodiagnosis↗
PubMedDate not supplied

Identifying lumbosacral radiculopathies: an optimal electromyographic screen.

OBJECTIVE: The objective of this study was to determine prospectively the optimal electromyographic screening examination of the lower limb that ensures identification of those lumbosacral radiculopathies that can be electrodiagnostically confirmed, yet minimizes the number of muscles studied. DESIGN: A prospective multicenter study was conducted from May 1996 to September 1997. Patients with suspected lumbosacral radiculopathy referred to participating electrodiagnostic laboratories were recruited and examined by needle electromyography using a standard set of muscles. Patients with electrodiagnostically confirmed lumbosacral radiculopathies were selected for analysis. Various muscle screens were tested against this group of patients with radiculopathies to determine the frequency with which each screen identified the patient with radiculopathy. RESULTS: There were 102 patients identified. When paraspinal muscles were one of the screening muscles, four-muscle screens identified 88-97% of the radiculopathies, five-muscle screens identified 94-98%, and six-muscle screens 98-100%. When paraspinal muscles were not part of the screen, identification rates were lower for all screens, and eight distal muscles were necessary to identify about 90% of the radiculopathies. CONCLUSIONS: Six-muscle screens with paraspinal muscles yielded consistently high identification rates. Studying additional muscles produced no improvements in identification.

Adult↗
PubMed2001

Identification of cervical radiculopathies: optimizing the electromyographic screen.

OBJECTIVE: To determine the optimal electromyography screening examination of the upper limb that ensures detection of those cervical radiculopathies, which can be electrodiagnostically confirmed, yet minimizes the number of muscles studied. DESIGN: A prospective multicenter study was conducted from May 1996 to September 1997 at five institutions. Patients who were referred to participating electrodiagnostic laboratories with suspected cervical radiculopathy were recruited. A standard set of muscles were examined by needle electromyography. Patients with electrodiagnostically confirmed cervical radiculopathies, based on electromyography findings, were selected for analysis. Muscle screens were tested against this group to determine whether the screen identified the patients with radiculopathy. RESULTS: There were 101 patients with cervical radiculopathies representing all cervical root levels. When paraspinal muscles were one of the screening muscles, five muscle screens identified 90% to 98% of radiculopathies, six muscle screens identified 94% to 99%, and seven muscle screens identified 96% to 100%. When paraspinal muscles were not part of the screen, eight distal limb muscles recognized 92% to 95% of radiculopathies. CONCLUSION: This study demonstrated that six muscle screens including paraspinal muscles yielded consistently high identification rates. Studying additional muscles led to marginal increases in identification.

Adolescent↗
PubMed2003

Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy.

STUDY DESIGN: A blinded, prospective diagnostic test study was conducted. OBJECTIVES: To assess the reliability and accuracy of individual clinical examination items and self-report instruments for the diagnosis of cervical radiculopathy, and to identify and assess the accuracy of an optimum test-item cluster for the diagnosis of cervical radiculopathy. SUMMARY OF BACKGROUND DATA: Although cervical radiculopathy remains largely a clinical diagnosis, the reliability and diagnostic accuracy of clinical examination items, individually or in combination, for cervical radiculopathy is largely unknown. METHODS: Patients with suspected cervical radiculopathy or carpal tunnel syndrome received standardized electrophysiologic examination of the symptomatic upper quarter followed by a standardized clinical examination by physical therapist examiners blinded to diagnosis. Diagnostic properties were assessed using a neural impairment reference criterion standard. RESULTS: The study involved 82 patients. More than two thirds of 34 clinical examination items had reliability coefficients rated at least fair or better, and 13 items had likelihood ratio point estimates above 2 or below 0.50. A single diagnostic test item cluster of four variables was identified and produced a positive likelihood ratio point estimate of 30.3. The 95% confidence intervals for all likelihood ratio point estimates in this study were wide. CONCLUSIONS: Many items of the clinical examination were found to be reliable and to have acceptable diagnostic properties, but the test item cluster identified was more useful for indicating cervical radiculopathy than any single test item. Upper limb tension Test A was the most useful test for ruling out cervical radiculopathy. Further investigation is required both to validate the test item cluster and to improve point estimate precision.

Adult↗
PubMed2000

Diagnosis and nonoperative management of cervical radiculopathy.

STUDY DESIGN: Qualitative, comprehensive literature review. OBJECTIVE: To discuss and summarize the current peer-reviewed literature related to the management of patients with cervical radiculopathy. BACKGROUND: Cervical radiculopathy is a lesion of the cervical spinal nerve root with a reported prevalence of 3.3 cases per 1000 people; peak annual incidence is 2.1 cases per 1000 and occurs in the fourth and fifth decades of life. Nerve root injury has the potential to produce significant functional limitations and disability. METHODS AND MEASURES: A search of the MEDLINE, CINAHL, and Web of Science databases for the periods 1966, 1982, and 1996, respectively, to December 1999 was conducted using selected keywords and MeSH headings. The bibliography of all retrieved articles were searched and pertinent articles were obtained. The Cochrane Database of Systematic Reviews was also searched. Literature related to the diagnosis, prognosis, and treatment of cervical radiculopathy were thoroughly reviewed and summarized using a critical appraisal approach. RESULTS: Although cervical radiculopathy remains largely a clinical diagnosis, the true diagnostic accuracy of the clinical examination for cervical radiculopathy is unknown. Imaging and electrophysiologic tests are capable of detecting clinically significant problems in many patients and each modality has inherent strengths and weaknesses; technical as well as practical factors affect the choice of procedure. The natural course of cervical radiculopathy appears to be generally favorable but no prognostic or risk factors have been firmly established and the efficacy of various nonoperative treatments for the condition is unknown. CONCLUSION: A clear definition of terms and further research are required to establish definitive diagnostic criteria and effective treatment for the management of patients with cervical radiculopathy.

Diagnosis, Differential↗
PubMed2003

Diabetic cervical radiculopathy with adhesive capsulitis of the shoulder.

The common form of diabetic neuropathy is symmetrical peripheral polyneuropathy, which involves the distal part of the lower extremities whereas diabetic amyotrophy is seen in the proximal part of the lower extremities. Although other regions may also be affected, the presence of upper extremity involvement has rarely been emphasized. Diabetic radiculopathy may involve the cervical region before, after, or concurrently with lumbosacral radiculopathy. We report 2 rare cases of diabetic radiculopathy which involves the cervical region without involving the lumbosacral region. To our knowledge, these are the first reported cases of diabetic radiculopathy involving the cervical region only. In our cases, severe adhesive capsulitis in a shoulder was noticed together with cervical radiculopathy. Both diabetic radiculopathy and adhesive capsulitis have a poorly understood pathogenesis and their combined presence is presumed to be rare. Clinical features and management of cervical radiculopathy with adhesive shoulder capsulitis in 2 diabetic patients is described.

Bursitis↗
PubMedDate not supplied

Rotary manipulation for cervical radiculopathy: observations on the importance of the direction of the thrust.

OBJECTIVE: To describe the clinical presentation of eight patients with cervical spine radiculopathy, the manipulation technique used for each patient and the outcomes of treatment. CLINICAL FEATURES: The cause of radiculopathy in four patients was disc herniation. The other four patients had a combination of spondylosis, disc herniation and sprain injury. INTERVENTION AND OUTCOME: Six of eight patients had a good outcome associated with receiving manipulation performed by contacting the cervical spine at the level of the radiculopathy, laterally flexing toward the side of radiculopathy, rotating the neck away from the side of the radiculopathy and applying a gentle high-velocity, low-amplitude thrust. Two patients had an exacerbation of arm pain and increased neurological deficit associated with manipulation performed with the neck rotated toward the side of radiculopathy. CONCLUSION: There is little compelling evidence supporting or disputing the use of manipulation for patients with cervical spine radiculopathy. In our patients, rotary manipulation was associated with a different outcome depending on the direction of neck rotation. Prospective time-series studies and randomized, blind trials are needed to identify the efficacy and effectiveness of different manipulation techniques for this condition.

Adult↗
PubMed1994

Experimental lumbar radiculopathy. Behavioral and histologic changes in a model of radicular pain after spinal nerve root irritation with chromic gut ligatures in the rat.

OBJECTIVE: The recently proposed animal model of lumbar radiculopathy was used to investigate behavioral consequences and histologic changes in spinal nerve roots, dorsal root ganglia, and spinal nerves after the L4, L5, and L6 nerve roots were loosely ligated with either silk or chromic gut sutures in an attempt to better understand the pathophysiologic mechanisms that give rise to pain associated with lumbar radiculopathy. SUMMARY OF BACKGROUND DATA: Little is known about the pathophysiologic mechanisms that give rise to pain associated with lumbar radiculopathy. The recently proposed animal model of unilateral lumbar radiculopathy, which demonstrated an association with motor paresis and thermal hyperalgesia of the affected hind limb and showed evidence of spontaneous pain has been demonstrated, may serve as a vehicle to allow direct investigation of the nature of the pathophysiological mechanisms associated with lumbar radiculopathy. METHODS: Three distinct treatments of the nerve roots were initially investigated: 1) a sham intervention, where the surgery simply exposed the nerve roots and dorsal root ganglion followed by standard closing procedures; 2) 4-0 silk ligature, where two loose ligatures of 4-0 silk were placed around the nerve roots; and 3) 4-0 chromic gut 2, where four 0.3 cm pieces of 4-0 chromic gut were laid adjacent to the nerve roots and secured by two loose ligatures of 4-0 chromic gut. STUDY DESIGN: ANOVA techniques were used to test for differential effects across time for the three treatment groups in terms of animal function. A qualitative analysis of the histology of the ipsilateral and contralateral nerve roots, dorsal root ganglia, and spinal nerves was done to correlate histologic changes with behavioral changes. RESULTS: Behavioral results were consistent with the previous study. Rats treated with chromic gut, but not silk, reliably demonstrated a prolonged thermal hyperalgesia that was maximal 2 weeks after surgery and lasted for up to 12 weeks. These behavioral changes, however, were not correlated with histologic changes in myelinated fiber content in the L4, L5, and L6 nerve roots, dorsal root ganglia and spinal nerves, the ipsilateral spinal nerved, dorsal root ganglia, and nerve roots of rates ligated with silk or chromic gut showed similar, significant, decreased in the number of large diameter myelinated fibers. CONCLUSIONS: These results suggest that mechanical constriction of the L4, L5, and L6 spinal nerve roots, as evidenced by a loss of myelinated fibers, is not sufficient to produce the behavioral effects associated with this model of lumbar radiculopathy. It is hypothesized that chemical factors from the chromic gut play a role in the pathophysiology and development of the behavioral, but not histological, changes in this model of lumbar radiculopathy.

Animals↗
PubMed1978

H reflex latency in radiculopathy.

This study was designed to evaluate whether the H reflex latency obtained from the triceps surae following tibial-nerve stimulation was of value in detecting and differentiating S1 from L5 radiculopathy. Thirty-two patients were studied, 15 with a definite unilateral L5 radiculopathy and 17 with a definite unilateral S1 radiculopathy. Data revealed a mean H reflex latency difference of 0.03 msec (range--0.1 to 0.2 msec) between the affected and unaffected extremities for the 15 patients with L5 radiculopathy and of 2.9 msec (range 1.3 to 4.1 msec) for the 13 patients with S1 radiculopathy where an H reflex could be recorded. The H reflex was unobtainable in the affected extremity in four of the patients with S1 radiculopathy. It is concluded that H reflex latency testing is a valuable tool in helping to differentiate S1 from L5 radiculopathy.

Adult↗
PubMed1996

The importance of paraspinal muscle EMG in cervical and lumbosacral radiculopathy: review of 100 cases.

It is well known that examination of the paraspinal muscles are an important part of the electrodiagnostic (EDX) evaluation of a patient with suspected radiculopathy. However, many electromyographers hesitate to routinely include this in their study. A random retrospective chart review was performed on 49 patients with cervical radiculopathy and 51 patients with lumbosacral radiculopathy to determine the frequency of EDX abnormalities in the paraspinal muscles and limb muscles. Criteria for abnormality was the presence of spontaneous activity in two muscles in a myotomal pattern in the limb, or in the paraspinal muscles. It was found that 20 out of 49 (40.8%) of the cervical radiculopathies and 10 out of 51 (19.6%) of the lumbosacral radiculopathies had abnormalities restricted only to the paraspinal muscles. These results indicate that especially in the cervical spine, a significant percentage of patients with radiculopathy will be missed if examination of the paraspinal muscles are not part of the EDX evaluation of the patient with suspected radiculopathy.

Adult↗