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At least 19 recordsLinked to original sources

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↗

PubMedDate not supplied

Diabetic thoracic radiculopathy: electrodiagnostic study.

We investigated the diagnostic value of electromyographic (EMG) examination of the anterior abdominal wall muscles (AWMS) in thoracic radiculopathy and compared it with examination of thoracic paraspinal muscles (TPSM). Technically, examination of AWMS was much easier compared to TPSM. In eight patients with thoracic diabetic radiculopathy at the level of T7-T12, AWMS was abnormal in all and was considered to be diagnostic, whereas AWMS was normal in diabetic lumbar radiculopathy, patients with diabetes mellitus without radiculopathy, patients with unspecified gastrointestinal pain, and patients with musculoskeletal-type back pain. We conclude that EMG evaluation for possible thoracic radiculopathy should include examination of AWMS, and if abnormal, would be of great diagnostic help in patients with unspecified gastrointestinal symptoms.

Abdominal Muscles↗

PubMed1991

A prospective study of acute radiculopathy after scoliosis surgery.

We have prospectively studied 45 patients undergoing scoliosis surgery (48 procedures) for evidence of postoperative acute radiculopathy. Posterior spinal fusion was performed in 42 patients (Cotrel Dubousset 28, Harrington rod with wires 9, Hartshill rectangles 5); anterior spinal fusion in 5 (Webb Morley) and an anterior release procedure in 5. Fourteen patients (29%) had sensory and/or motor signs of radiculopathy post-operatively, with moderate to severe symptoms in 10 and mild symptoms in 4. The radiculopathies were considered traumatic in 7 patients, in whom radiculopathy correlated with placement of a hook or passage of a sublaminal wire. In the remaining 7 patients, traction was considered the likely mechanism of injury; in these there was a significant association with the degree of postoperative correction of the scoliosis where it was substantially beyond the preoperatively demonstrated flexible range (p = 0.008). A system of intraoperative electromyographic monitoring for possible prevention of this complication is described. Radiculopathy is a common complication of scoliosis surgery.

Acute Disease↗

PubMed1991

The H or F wave latencies in medial gastrocnemius in the electrodiagnostic study of sciatica patients with suspected S1 radiculopathy.

The aim of this study was to test H or F wave latencies of medial head of gastrocnemius muscle for electrodiagnostic evaluation of patients with suspected S1 radiculopathy with or without additional L5 radiculopathy. A group of 97 patients (34 female and 63 male), aged 20-60 (average 44 years), with clinically suspected unilateral radiculopathy were studied. Needle EMG of medial gastrocnemius muscle was supplemented by H or F wave latencies measurement bilaterally by percutaneous stimulation of tibial nerve in cubital fossa. EMG abnormalities indicating S1 radiculopathy were followed by H or F wave latencies abnormality in 63% of patients. The rest of 37% of patients of these group showed mild EMG abnormalities followed by normal H or F wave. Normal EMG finding was followed by normal H or F wave. Normal EMG finding was followed by normal H or F wave in 64% of patients. Increased latency of H or F wave without EMG abnormalities in gastrocnemius muscle was present in 36% of patients. The results of this study have proved that measurements of H of F latencies provide the objective evidence of S1 radiculopathy, presenting with the unilateral increase of latency or the absence of response. Abnormal H response latencies without EMG abnormality confirm the condition of sensory root affection only. Mild radicular affection in S1 distribution presented from early beginning or following recovery, was accompanied by normal H or F response, and therefore this test has prognostic value for the course of disorder.

Adult↗

PubMed2026

Ultrasound-guided high-voltage vs conventional pulsed radiofrequency in elderly cervical radiculopathy: A randomized controlled trial.

BACKGROUND: Elderly patients with cervical radiculopathy present therapeutic challenges owing to comorbidities and medication-related risks. Long-term pharmacotherapy and surgical interventions are often suboptimal, necessitating evaluation of optimized pulsed radiofrequency strategies under image guidance. OBJECTIVES: This superiority trial compared the efficacy and safety of ultrasound-guided cervical nerve root high-voltage pulsed radiofrequency (HVP-PRF) versus conventional pulsed radiofrequency (C-PRF) for pain management in elderly patients with cervical radiculopathy. METHODS: This single-center, parallel-group, assessor-blinded randomized controlled trial enrolled patients aged 60-85 years with cervical radiculopathy, randomly assigned (1:1) to HVP-PRF (70 V) or C-PRF (45 V). Procedures were performed under ultrasound guidance with sensory/motor stimulation confirmation and temperature ≤42°C. The primary outcome was change in upper-limb radiating pain on the Numeric Rating Scale (ΔNRS) from baseline to 3 months. Secondary outcomes included Neck Disability Index (NDI), neck pain NRS, Patient Global Impression of Change, responder rates, rescue analgesia use, and adverse events. Follow-up occurred at 1 week, 1, and 3 months. RESULTS: A total of 104 patients were randomized and 101 received treatment. At 3 months, HVP-PRF demonstrated significantly greater radiating pain improvement versus C-PRF (adjusted mean difference 1.24, 95% CI 0.46-2.02, P=0.002). Functional improvement (NDI) was superior in the HVP-PRF group at 3 months (AMD 6.47, 95% CI 2.11-10.83, P=0.004). Responder rates (≥50% pain reduction) were higher with HVP-PRF at 3 months (68.75% vs. 42.22%, OR 3.01, P=0.011) and 6 months (65.22% vs. 43.18%, OR 2.52, P=0.035). Rescue analgesic use was lower in the HVP-PRF group during 1-3 months intervals (both P<0.05). Adverse event rates were comparable (27.45% vs. 32.00%). CONCLUSION: Under ultrasound visualization and electrical stimulation-based target confirmation with temperature control ≤42°C, HVP-PRF provided greater and more durable relief of upper limb radiating pain compared with C-PRF in elderly patients with cervical radiculopathy, with a comparable safety profile.

Humans↗

PubMed1990

Pancoast tumor presenting as cervical radiculopathy.

A case of Pancoast tumor presenting as cervical radiculopathy is reported, including the clinical, EMG, and radiologic findings. A 64-year-old man with a two-month history of left shoulder pain and left arm numbness at the medial aspect of the hand and forearm presented for electrodiagnostic examination, and a severe C8 radiculopathy was documented. Subsequent radiologic evaluation (myelogram and routine chest x-ray) yielded the diagnosis of left apical lung tumor (Pancoast tumor), eroding through the C7 and T1 pedicles and T1 vertebral body, with cut-off of the left C8 nerve root. Pancoast tumor has long been implicated as a cause of brachial plexopathy. The EMG presentation of isolated cervical radiculopathy, however, has not been previously reported, despite the tumor's known tendency for local invasion which may include the nerve roots and even the spinal canal in its advanced stages. This patient's normal sensory studies argue against any significant coexisting lower brachial plexopathy. The possibility of Pancoast lesion should be considered not only in the presence of brachial plexopathy, but also when C8 or T1 radiculopathy is found.

Diagnostic Errors↗

PubMed1989

Regression of herniated nucleus pulposus: two patients with lumbar radiculopathy.

Thirty percent to 95% of patients with lumbar radiculopathy secondary to a bulging or herniated disc improve to a pain-free and functional level with nonsurgical treatment. What happens to the herniated disc material as this improvement occurs is unclear. We present two patients with lumbar radiculopathy documented by physical examination and electrodiagnostic testing. Both patients had herniated disc material at the L5 to S1 level on computed tomography (CT) scans corresponding to the side and level of their lesion on physical examination and electrodiagnostic testing. In both instances, the radiculopathy resolved with conservative treatment. CT scans were repeated in three months on one patient and four months on the other. The scans showed major resolution of the herniated disc material in both patients. These two cases demonstrate that in some patients with proven radiculopathy secondary to herniated nucleus pulposus, the herniated disc material will no longer be visible on CT scan and is presumed to resorb as the symptoms abate.

Adult↗

PubMed1988

AAEE minimonograph #32: the electrophysiologic examination in patients with radiculopathies.

A brief history of the evolution of radiculopathy as a clinical entity, and the use of electrodiagnostic studies to diagnose it, are provided. Root anatomy and the concept of myotomes and dermatomes are reviewed, as is the pathophysiology of radiculopathy. The value and limitations of the various electrophysiologic procedures used in the diagnosis of radiculopathies are discussed, including motor and sensory nerve conduction studies, late responses, somatosensory evoked potentials, nerve root stimulation, and the needle electrode examination. The specific muscles are enumerated which most often appear abnormal on needle electromyography with lesions of the various roots. The electrodiagnostic differentiation of root lesions from plexus lesions is described, and the various electrodiagnostic findings with lumbar canal stenosis are discussed. Finally, the value and limitations of the electrodiagnostic assessment in the evaluation of patients with suspected radiculopathies are reviewed.

Electrodiagnosis↗

PubMed1990

Spinal nerve stimulation in the diagnosis of lumbosacral radiculopathy.

Direct spinal nerve stimulation was compared with needle electromyography (EMG) in 40 patients who were suspected of having an L5 or S1 radiculopathy. For spinal nerve stimulation, we adapted a monopolar needle electrode inserted deep into the paraspinal muscle. The minimal latency, amplitude, and negative phase area of compound muscle action potential from myotomal muscles were recorded with computer assistance. Abnormality was considered to be significant when the value fell outside of 2 SD of control mean values. Among 17 patients with clinical evidence of radiculopathy, needle EMG was abnormal in 10 patients (58.8%), whereas in the nerve stimulation test the abnormalities were shown in 16 patients (94.1%); in amplitude difference and the abnormal area, differences were shown in 12 patients (70.6%). Among 23 patients with only subjective symptoms of radiculopathy, needle EMG was abnormal in nine patients (39.1%), whereas the abnormal amplitude differences were shown in 18 patients (78.3%) and 15 patients (65.2%) with abnormal area difference by spinal nerve stimulation, respectively. Direct spinal nerve stimulation is recognized as an objective and sensitive test in the diagnosis of lumbosacral radiculopathy.

Action Potentials↗

PubMed1988

Cervical laminaplasty: its role in the treatment of cervical radiculopathy.

Krita in 1968 described the use of laminaplasty for the treatment of cervical myelopathy. Since then, several authors have modified this technique, settling on the "expansive open door laminaplasty" as the technique of choice for cervical myelopathy. There have been no reports to date on the use of the cervical laminaplasty procedure for the treatment of cervical radiculopathy. The purpose of this paper is to report on the initial 16 patients undergoing this procedure for the surgical treatment of cervical radiculopathy due to cervical spondylosis and/or cervical spinal stenosis. There were 16 patients (8 males and 8 females) whose age ranged from 54 to 84 years, with a mean of 67.2 years. The follow-up average was 2.7 years, with a range of 2.1 to 5.5 years. Seven patients were categorized as having brachalgia-cord type myelopathy and nine patients were categorized as radiculopathy only. Arm pain was unilateral in seven patients and bilateral in nine patients. Of those with bilateral pain, eight patients had pain predominately in one arm, with one patient having equal left and right arm complaints. Cervical laminaplasty was carried out from C3-6 in six patients and C3-7 in six patients and one patient had each of the following: C4-7, C4-T1, C5-T1, and C3-T1. The results were excellent in five cases, good in nine, and poor in two. The results of patients with unilateral symptoms and signs were compared to those with bilateral findings using chi 2 analysis. There was no statistical difference when performing laminaplasty for patients with bilateral findings as opposed to unilateral symptoms and signs. The amount of spinal canal expansion obtained by the laminaplasty procedure ranged from 4 to 12 mm. The conclusions of this study were (a) laminaplasty appears to be an effective alternative to laminectomy or anterior cervical fusion for multilevel cervical spondylotic radiculopathy or myeloradiculopathy and (b) complications of anterior fusion and laminectomy are avoided with the laminoplasty procedure.

Aged↗

PubMed2026

Nonoperative Management is Associated With Similar Long-Term Patient-Reported Outcomes Compared With Surgery for Cervical Radiculopathy: A Systematic Review and Meta-analysis.

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To compare long-term patient-reported outcomes between surgical and nonoperative management for cervical radiculopathy. SUMMARY OF BACKGROUND DATA: Cervical radiculopathy is a common condition associated with substantial morbidity. While both surgical and nonoperative approaches are effective, it remains unclear which patients benefit most from each strategy and whether earlier operative intervention confers meaningful long-term advantage. MATERIALS AND METHODS: PubMed, Embase, and the Cochrane Library were searched from inception to January 2026 for randomized and observational studies comparing surgical and nonoperative management for cervical radiculopathy. Primary outcomes included visual analog scale (VAS) scores for neck and arm pain, neck disability index (NDI), and overall clinical success. Secondary outcomes included analgesia use and sick leave. Random-effects meta-analyses were performed using restricted maximum likelihood estimation. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence using GRADE. RESULTS: Eleven studies comprising 1154 patients (surgical: 522; nonoperative: 632) were included. Surgery was not associated with superior outcomes in VAS for arm pain (MD: -0.67, 95% CI: -1.59 to 0.26, P =0.12), VAS for neck pain (MD: -0.50, 95% CI: -1.38 to 0.38; P =0.19), or NDI (MD: -3.69, 95% CI: -9.63 to 2.25, P =0.16) after 12 months of treatment, nor in overall success (RR: 1.11, 95% CI: 0.93-1.34, P =0.21). No significant differences were observed in analgesia use ( P =0.54) or sick leave ( P =0.48) at last follow-up. Most studies were rated serious risk of bias and overall certainty of evidence was moderate. CONCLUSION: Evidence from this pooled analysis suggests that long-term pain, disability, and functional outcomes are comparable between patients selected for nonoperative management and those selected for surgery. These findings reflect outcomes within selected cohorts and should not be interpreted as evidence of therapeutic equivalence. LEVEL OF EVIDENCE: Level II.

Humans↗

PubMed1986

Cervical radiculopathy. Clinical, radiographic and EMG findings.

This retrospective study reviewed clinical, radiographic, and electromyographic (EMG) findings in 108 patients with cervical radiculopathy. Radiographic evaluation included measurements of the size of the intervertebral foramina and the space for the intervertebral disk. The results showed that the clinical findings correlated well with the EMG abnormalities but not with the radiographic findings. The extent of the intervertebral foramen and the disk space narrowing correlated poorly with the severity of EMG abnormalities. It is suggested that radiographic findings alone may be an inadequate basis for a diagnosis of cervical radiculopathy. EMG examination may be very helpful in such a diagnosis and may be more accurate in assessing radiculopathy than the plain films in certain cases.

Adult↗

PubMed1985

Dermatomal somatosensory evoked potentials in unilateral lumbosacral radiculopathy.

We examined scalp-recorded somatosensory evoked potentials (SSEPs) to electrical stimulation of the peroneal nerves and to stimulation in the L5 and S1 dermatomes in 19 patients with unilateral radiculopathies involving these segments. For the dermatomal studies at least two trials of 512 responses were recorded from the vertex with reference to both the midfrontal and contralateral parietal electrodes, using an averaging technique. Findings on the symptomatic and asymptomatic sides were compared in each patient. We found that peroneal SSEPs were normal in all patients. Dermatomal SSEPs correctly identified the lesion in 5 patients. In 1 patient dermatomal SSEPs lateralized the lesion correctly but localized it to the adjacent root. In 10 cases dermatomal SSEPs gave misleading information, indicating an abnormality on the asymptomatic side in 1 patient and no abnormality in 9. In the remaining 3 patients, both SSEPs and radiological contrast studies failed to identify any lesion, although the radiculopathy was confirmed by electromyography. These findings raise doubt about the ultimate utility of these evoked potential techniques in the evaluation of patients with suspected radiculopathies.

Adult↗

PubMed1987

Surgical and conservative treatment of cervical spondylotic radiculopathy and myelopathy.

One hundred and fourteen patients were admitted to our department for evaluation of their cervical spondylogenetic symptoms, including local cervical pain, radiculopathy and myelopathy. This retrospective study gives the results, expressed as improved, unchanged or worse, of anterior surgery, posterior surgery and conservative treatment. Local cervical pain improved in about half of the patients, without any difference between the groups. The effect of surgery on radiculopathy was superior to that of conservative treatment, 71 percent and 74 percent respectively, being improved after anterior and posterior surgery, compared to 19 percent in the conservatively treated group. The majority of patients with myelopathy were treated with posterior surgery and 69 percent had improved. The results were not influenced by the patients age or the duration of symptoms. It is argued that the positive effects of surgery on the radiculopathy are due to a segmental stabilisation rather then to decompression. The immediate post-operative improvement of the myelopathy is undoubtedly caused by the decompression while the long-termed improvement cannot with certainty be attributed to the operation.

Adult↗

PubMed1992

Somatosensory evoked potentials (cutaneous nerve stimulation) and electromyography in lumbosacral radiculopathy.

In order to evaluate the usefulness of SEP with cutaneous nerve stimulation in lumbosacral radiculopathy, we investigated 19 patients by EMG including H-reflex and SEP. All patients had radiculopathy proven by myelography and/or CT scan and, if indicated, operative treatment. The findings by EMG and SEP were compared with operative and radiological findings. In this preliminary study, SEP was as sensitive as EMG in detecting lumbosacral radiculopathy. Further investigation seems justified.

Adult↗

PubMed1991

A quantitative evaluation of sensory dysfunction in lumbosacral radiculopathy.

A quantitative evaluation of sensory disturbance of the foot was attempted in 94 cases of lumbosacral radiculopathy using the biothesiometer, the Semmes-Weinstein esthesiometer, light touch, tuning fork, and dermatomal somatosensory evoked potentials. Dermatomal somatosensory evoked potentials was the most sensitive of these tests, and reflected the duration of the lumbosacral radiculopathy better than the biothesiometer and the Semmes-Weinstein esthesiometer. The biothesiometer and Semmes-Weinstein esthesiometer reflected the clinical severity of sensory dysfunctions, the extent of numbness, and the immediate change in sensory function better than the dermatomal somatosensory evoked potentials. It is important to understand the characteristics of each test and to choose informative tests for clinical use. Grades of sensory disturbance in patients with lumbosacral radiculopathy were classified into three categories in combination with the findings of dermatomal somatosensory evoked potentials and the values recorded with the biothesiometer and Semmes-Weinstein esthesiometer.

Adult↗

PubMed1986

C7 radiculopathy: importance of scapular winging in clinical diagnosis.

Lesions of the seventh cervical (C7) root are common and cause a readily recognised neurological syndrome. Recognition of this pattern is essential in differentiating C7 root lesions from lesions of the brachial plexus or peripheral nerves. Serratus anterior weakness is not generally included in this syndrome. We report six verified cases of C7 radiculopathy in which weakness of the serratus anterior was present in addition to the usual findings. This was manifest as winging of the scapula, when pushing forward against a wall, either with the hands at shoulder level or, in some cases, only when the hands were lowered to waist level. This latter method of testing places the muscle at a mechanical disadvantage and reveals partial paralysis. Analysis of this clinical finding complements anatomical evidence suggesting that the powerful lower digitations of the muscle may be primarily supplied by the C7 root in some cases. Scapular winging, apparent either in the usual position or the modified position described here, should be recognised as consistent with a diagnosis of C7 radiculopathy. When present, this sign serves to differentiate C7 radiculopathy from lesions of the brachial plexus or radial nerve.

Adult↗

PubMed1987

Cervical root stimulation in the diagnosis of radiculopathy.

Cervical root stimulation (CRS) was compared with conventional EMG, nerve conduction, and late response studies in 34 patients with possible cervical radiculopathy. Cervical roots were stimulated by monopolar needles inserted into paraspinal muscles, recording compound muscle action potentials in biceps, triceps, and abductor digiti minimi muscles. In 18 patients with clinical evidence of radiculopathy, EMG was abnormal in 11 (61%), but CRS was abnormal in all 18. Of 16 patients with symptoms but no signs of radiculopathy, EMG was abnormal in 5 (31%) and CRS was abnormal in 9 (56%).

Action Potentials↗