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Abstract
The aim of this work was to assess the electrophysiological studies and MRI finding in patients with lumbosacral radiculopathy in order to determine how they correlate with one another and with the clinical syndrome. In the present study, twenty patients suffering from discogenic lumbosacral radiculopathy were included; they were five females and fifteen males. They were divided clinically into two groups (definite and probable) according to Nardin et al., (1999).All subjects of the study were subjected to the following:
? Complete history taking. Complete clinical examination with stress on the neurological examination.Nerve conduction studies. Late responses (F-wave).? EMG. Lumbosacral MRI. from this study, we found that:There was significant correlation between subjective muscle weakness with the nerve root injury. Radicular leg pain was the most sensitive and accurate symptom in diagnosis of lumbosacral radiculopathy. There was a significant correlation between abnormal muscle ppower examination, abnormal dermatomal sensory examination and positive SLR with lumbosacral nerve roots injury. The most sensitive and accurate sign was the abnormal muscle power examination. The most common affected root was L5. Peroneus longus muscle was the most muscle had EMG abnoramlities with L5 radiculopathy.
? Gastrocnemuius muscle was the most muscle had EMG abnormalities with S1 radiculopathy.
? F-wave abnormalities and motor nerve conduction studies were considered as low sensitive test in diagnoses of lumbosacral radiculopathy.
? The most useful electrophysiologic technique in the evaluation of patients with suspected radiculopathy was EMG.
? MRI had high false positive results.
? MRI could not differentiate between the two clinical groups (P > 0.05).
? EMG had good agreement with clinical diagnosis (P < 0.05).
? In patients with lumbosacral nerve root injury, MRI was more sensitive in diagnosis than EMG; But the EMG was more specific.
? Using of MRI and EMG together increase the accuracy of diagnosis.
CONCLUSION
MRI is optimal screening investigation for discogenic lumbosacral radiculopathy.
It identifies the structural abnormalities within the lumbar spine. Patients with a higher probability of discogenic nerve compression are usually definite surgical candidates.
MRI usually used in both diagnosis and surgical planning. However, the MRI has shown to give high false positive results up to (75%) in some studies.
Identification of patients with nerve root injury is very essential for these patients undergone surgical intervention.
Electodiagnostic studies can give useful information about the severity of nerve root injury and level localization of that root.
So, MRI assesses anatomical state while electrophysiological studies assess the physiological state of the nerve roots. Therefore, both tests are complementary to each other especially for decision of surgical interference.