제4, 5 요추 추간판 탈출증에 의한 제 5 요수 신경근병증의 침근전도 양상
Needle Electromyographic Findings in L5 Radiculopathy Caused by L4-5 Intervertebral Disc Displacement
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Objectives: To determine selecting ideal muscles in evaluating L5 radiculopathy through electrophysiologic study. Methods: Electrophysiologic cases which were confirmed for L5 radiculopathies were studied, excluding peripheral neuropathy other than L5 radiculopathy, myelopahty or recent spine surgery less than 3 years. Twenty-seven patients presented with clinical findings of L5 radiculopathy included. The clinical diagnosis of L5 radiculopathy and intervertebral disc displacement in the 4th and 5th lumbar level was confirmed by magnetic resonance imaging (MRI). Patients with peripheral neuropathy other than L5 radiculopathy, myelopathy or recent spine surgery less than 3 years were excluded. We performed electrophysiologic studies in muscles defined by two different categories: paravertebral, proximal and distal groups. Results: Muscles of extensor hallucis longus (79%), extensor digitorum longus (75%), tibialis anterior (70%), paravertebral muscle (62%), peroneus longus (62%), tensor fascia lata (60%), gluteus medius (38%) and lateral head of gastrocnemius (33%) showed abnormal findings in needle electromyography. Including even one abnormal finding in any muscle in each group, the distal group showed the highest rate of abnormalities such as 100% whereas proximal and paravertebral group showed each rate as 68% and 65% in order. Tensor fascia lata muscle and extensor hallucis longus muscle showed the highest rate of abnormalities in each group. Conclusion: We propose that tensor fascia lata in proximal and extensor hallucis longus in distal muscle groups should be selected in L5 radiculopathy.
Abstract
Objectives: To determine selecting ideal muscles in evaluating L5 radiculopathy through electrophysiologic study. Methods: Electrophysiologic cases which were confirmed for L5 radiculopathies were studied, excluding peripheral neuropathy other than L5 radiculopathy, myelopahty or recent spine surgery less than 3 years. Twenty-seven patients presented with clinical findings of L5 radiculopathy included. The clinical diagnosis of L5 radiculopathy and intervertebral disc displacement in the 4th and 5th lumbar level was confirmed by magnetic resonance imaging (MRI). Patients with peripheral neuropathy other than L5 radiculopathy, myelopathy or recent spine surgery less than 3 years were excluded. We performed electrophysiologic studies in muscles defined by two different categories: paravertebral, proximal and distal groups. Results: Muscles of extensor hallucis longus (79%), extensor digitorum longus (75%), tibialis anterior (70%), paravertebral muscle (62%), peroneus longus (62%), tensor fascia lata (60%), gluteus medius (38%) and lateral head of gastrocnemius (33%) showed abnormal findings in needle electromyography. Including even one abnormal finding in any muscle in each group, the distal group showed the highest rate of abnormalities such as 100% whereas proximal and paravertebral group showed each rate as 68% and 65% in order. Tensor fascia lata muscle and extensor hallucis longus muscle showed the highest rate of abnormalities in each group. Conclusion: We propose that tensor fascia lata in proximal and extensor hallucis longus in distal muscle groups should be selected in L5 radiculopathy.
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