Medicine
Mehrdad Zamani Esfahlani; Saeid Charsouei
Abstract
Introduction: Surface electromyography (sEMG) changes as a result of traumatic spinal cord injury (SCI), which disrupts spinal and supraspinal pathways. The sEMG is a useful addition to current clinical testing and can capture the residual motor command in great detail, even in muscles below the level ...
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Introduction: Surface electromyography (sEMG) changes as a result of traumatic spinal cord injury (SCI), which disrupts spinal and supraspinal pathways. The sEMG is a useful addition to current clinical testing and can capture the residual motor command in great detail, even in muscles below the level of injury with seemingly absent motor activities. We aimed to explain how the sEMG properties are altered after SCI in this in-depth review.Material and Methods: Following a thorough review of the literature, we focused on sEMG analysis methods and signal characteristics post-SCI. Early reports, according to what we discovered, tended to be primarily concerned with the qualitative analysis of sEMG patterns before moving on to semi-quantitative scores and a more thorough amplitude-based quantification.Results: On the other hand, recent studies are still limited to an amplitude-based analysis of the sEMG, and there are opportunities to more thoroughly characterize the time- and frequency-domain properties of the signal as well as to fully utilize high-density EMG techniques. We advise incorporating a wider variety of signal properties into the neurophysiological evaluation following SCI and gaining a better understanding of the relationship between these sEMG properties and underlying physiology.Conclusion: Improved sEMG analysis may help in understanding the mechanisms of change after neuromodulation or exercise therapy, as well as provide a more thorough description of how SCI affects upper and lower motor neuron function and their interactions.
Medicine
Saeid Charsouei; Mehrdad Zamani Esfahlani
Abstract
Introduction: There do not appear to be any distinct, accepted clinical or investigative standards for the diagnosis or, more importantly, the selection of cervical radiculopathy patients for surgery. To decide who to operate on and to give our patients a realistic prognosis estimate, it is critical ...
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Introduction: There do not appear to be any distinct, accepted clinical or investigative standards for the diagnosis or, more importantly, the selection of cervical radiculopathy patients for surgery. To decide who to operate on and to give our patients a realistic prognosis estimate, it is critical that we can pinpoint the subgroup most likely to benefit from surgery. The purpose of this study is to determine whether electromyography (EMG) studies can be used to pinpoint the subgroup that will recover more favorably from surgery.Material and Methods: The latency of muscle contractions is measured by recording MEPs, and the CMCT is calculated by subtracting the latency of nerve conduction from the cerebral cortex to the muscle via the corticospinal tract from the latency of nerve conduction between the spinal nerve root and the muscle where an electrode was attached. For BB-CMCT, APB-CMCT, and TA-CMCT, the cut-off values are 8 to 9 ms, 18 ms, and 20 ms, respectively.Results: In the entire sample, there was a 40% agreement between NPS, MRI, and the level or levels that had undergone surgery. In group A, two patients' sensory nerve conduction studies show associated evidence of median nerve compression at the wrist. In group B, none of the patients had evidence of nerve root compression on preoperative NPS, but all of the patients had evidence of disc bulge and narrowing of the exit foramina on MRI scans.Conclusion: This study has shown that preoperative NPS is useful in determining which cervical radiculopathy patients will benefit most from surgery. Patients who undergo preoperative abnormal needle EMG examination will likely benefit from surgical decompression and fusion much more than those who undergo preoperative normal EMG. Therefore, whenever evaluating a patient with cervical radiculopathy.
