Article

OBJECTIVE: To assess the neurophysiologic changes in a group of patients with
lumbar radiculopathy 5 to 12 months after their first electromyographic
examination. DESIGN: A prospective group of patients with a case definition of
lumbar radiculopathy was reassessed between 5 and 12 months after their first
clinical, functional, imaging, and neurophysiologic evaluation.
Both the lumbar
paraspinals (in which the mini-mapping technique was used) and the same lower
limb muscles were explored in every patient. Relevant abnormalities were (1)
positive sharp waves/fibrillation potentials, (2) polyphasic motor unit
potentials, and (3) large-amplitude/long-duration motor unit potentials. Patients
were sorted into 5 groups based on the type and distribution of neurophysiologic
abnormalities: from 0 (no abnormalities) to 4 (denervation signs in 2 lower limb
muscles and paraspinals). Patients' subjective perception of any improvement or
worsening of their condition was also recorded.
SETTING: A referral center for
neurophysiologic evaluation. PARTICIPANTS: A consecutive sample of patients
(N=91) with a clinical definition of lumbar radiculopathy (lumbar pain radiating
down the leg and below the knee) referred for neurophysiologic assessment was
selected for an initial clinical, functional, and neurophysiologic evaluation.
Patients were called for a second evaluation (between 5 and 12mo). Thirty-eight
(42% of the initial sample) were willing/eligible for the second evaluation.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Changes in (1)
electromyographic results; (2) patients' subjective perception of pain; and (3)
quality of life, based on the Roland-Morris Questionnaire and Medical Outcomes
Study 36-Item Short-Form Health Survey scores. RESULTS: Paraspinal muscles were
most frequently affected. Neurophysiologic abnormalities had improved on
reassessment. Clinical improvement was more significant for those patients with
initially abnormal electromyographic results. CONCLUSIONS:
There was clinical as
well as electromyographic improvement in patients with lumbar radiculopathy
within the first year of the initial diagnosis.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS