1. A preoperative and postoperative study of the accuracy and value of electrodiagnosis in patients with lumbosacral disc herniation
- Author
-
J Isaccsson, P Grane, E Svanborg, and T Tullberg
- Subjects
Adult ,Male ,medicine.medical_specialty ,Sacrum ,Nerve root ,Neural Conduction ,Lumbar vertebrae ,Sensitivity and Specificity ,Predictive Value of Tests ,Evoked Potentials, Somatosensory ,medicine ,Humans ,Orthopedics and Sports Medicine ,Lumbar Vertebrae ,business.industry ,Electromyography ,Middle Aged ,Surgery ,Intervertebral disk ,medicine.anatomical_structure ,Treatment Outcome ,Dermatome ,Somatosensory evoked potential ,Predictive value of tests ,Female ,Neurology (clinical) ,Abnormality ,business ,Tomography, X-Ray Computed ,Lumbosacral joint ,Intervertebral Disc Displacement - Abstract
Twenty patients with a radicular syndrome, who underwent surgery for unilevel lumbosacral disc herniations verified by computed tomography were investigated with neurophysiologic tests (electromyograms, F-responses, dermatome somatosensory evoked potentials) preoperatively and 1 year postoperatively. At least one test revealed a pathologic abnormality preoperatively in 13 patients, but in 5 patients only the nerve root level corresponded to computed tomographic findings. Discordance between neurophysiologic and radiologic findings did not predict a surgical success rate. if all neurophysiologic tests were normal the outcome was significantly worse than if any of the tests showed an abnormality (P < 0.01). Four patients who were improved after surgery still had abnormal neurophysiologic findings. In conclusion, neurophysiology is not useful to diagnose the exact level of a nerve root lesion, but may reveal whether it is present. Electrodiagnosis is recommended if radiology and clinical testing conflict. If positive, it may then serve to justify surgical exploration.
- Published
- 1993