Document Type : Review Article
Authors
1 Associate Professor of Neurology, Department of Neurology, School of Medicine, Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Assistant Professor of Spine Surgery, Department of Orthopedics, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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 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.
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