Department of Physical Medicine and Rehabilitation, Wooridul Spine Hospital, Seoul, Korea.
J Rehabil Med. 2012 Oct;44(10):845-50. doi: 10.2340/16501977-1034.
To compare the clinical implications of electro-diagnostic study with those of magnetic resonance imaging in patients with lumbosacral intervertebral herniated disc or spinal stenosis.
Retrospective study of clinical data.
Patients with lumbosacral intervertebral herniated disc or spinal stenosis, diagnosed by clinical assessment and magnetic resonance imaging (MRI), were selected. A total of 753 patients (437 with lumbosacral intervertebral herniated disc and 316 with spinal stenosis) were included in the study.
Clinical data for electrodiagnostic study (EDX)and MRI were compared and the sensitivity and specificity of these studies were evaluated. Among all subjects, 267 had radiculopathy on EDX (EDX (+)) and 486 no radiculopathy (EDX(-)). Furthermore, 391 had root compression on MRI (MRI (+)) and 362 no root compression on MRI (MRI (-)).
Patients with radioculopathy on EDX (+) showed a significantly higher visual analogue scale score for radiating pain and a higher Oswestry Disability Index than those with negative findings by EDX (-) in the total subjects group and the lumbosacral intervertebral herniated disc subgroup, and there was a trend toward higher Oswestry Disability Index in the spinal stenosis subgroup. Although patients with radioculopathy on root compression on MRI (+) also had a higher visual analogue scale for radiating pain than patients with negative findings by MRI (-) in the total subjects group and the lumbosacral intervertebral herniated disc subgroup, no significant difference was seen in the Oswestry Disability Index. EDX revealed a significant correlation with muscle weakness in the total subjects group and the lumbosacral intervertebral herniated disc subgroup, and trends toward muscle weakness in the spinal stenosis subgroup, whereas there was no such significant correlation for MRI findings in any group. Electrodiagnostic study had a higher specificity in terms of physical examination data than MRI, in spite of its lower sensitivity.
Electrodiagnostic study was significantly more correlated with clinical data, especially leg muscle weakness and functional status, and showed a higher specificity than MRI in patients with lumbosacral intervertebral herniated disc or spinal stenosis.
比较电诊断研究与磁共振成像（MRI）在腰骶椎间盘突出症或椎管狭窄症患者中的临床意义。
临床资料回顾性研究。
选择经临床评估和 MRI 诊断为腰骶椎间盘突出症或椎管狭窄症的患者。共纳入 753 例患者（437 例腰骶椎间盘突出症，316 例椎管狭窄症）。
比较电诊断研究（EDX）和 MRI 的临床资料，并评估这些研究的敏感性和特异性。在所有患者中，267 例 EDX 存在神经根病（EDX（+）），486 例无神经根病（EDX（-））。此外，391 例 MRI 存在神经根受压（MRI（+）），362 例 MRI 无神经根受压（MRI（-））。
EDX（+）的放射性神经根病患者的放射痛视觉模拟评分和 Oswestry 残疾指数均显著高于 EDX（-）患者，在总患者组和腰骶椎间盘突出症亚组中存在这种趋势，而在椎管狭窄症亚组中 Oswestry 残疾指数也有升高的趋势。尽管总患者组和腰骶椎间盘突出症亚组中 MRI 神经根受压阳性患者的放射痛视觉模拟评分也高于 MRI 阴性患者，但 Oswestry 残疾指数无显著差异。EDX 在总患者组和腰骶椎间盘突出症亚组中与肌肉无力显著相关，在椎管狭窄症亚组中也有肌肉无力的趋势，而 MRI 结果在任何组中均无显著相关性。尽管 EDX 的敏感性较低，但在体格检查数据方面的特异性明显高于 MRI。
电诊断研究与腰骶椎间盘突出症或椎管狭窄症患者的临床数据，特别是下肢肌肉无力和功能状态相关性更显著，特异性高于 MRI。
