Validity of diagnostic tools in determining the operation level

in multilevel cervical radiculopathy -analysis between physical finding, MRI, and EMG-

        

Byung-Wan Choi, M.D., Kyung-Jin Song, M.D. *

Hun Park, M.D. * and Kwang-Bok Lee, M.D. *

Departments of Orthopedic Surgery

Gwangju Veterans Hospital ,

Chonbuk National University Hospital *

-We have no financial relationships to disclose-

The purpose of this study was to verify the

usefulness and validity of each diagnostic tools

by comparing between physical examination,

MRI, and EMG findings in multilevel cervical

radiculopathy which performed operative

treatment.

PURPOSE

Demographic Data

Physical Examination

EMG

Standardized electrophysiological examination

- nerve conduction studies (NCS)

concentric needle EMG

Viking (Nicolet, Wisconsin, USA)

Evidence of denervation

- the presence of spontaneous activities

(fibrillations, positive sharp waves and fasciculations)

- long duration polyphasic motor units.

MRI

MRI(1.5 T Magneton vision, SIEMENS, Elangen, Germany)

Gold Standard

- Positive: confirmed by operation

- Negative: no pathology (in PE, MRI, EMG).

the segments not included in operation

Method

Comparing with operation findings,

1. Sensitivity

2. Specificity

3. Positive predictive value

4. Negative predictive value

For comparing between each diagnostic values,

Pearson correlation ratio was evaluated.

RESULTS

Abnormal finding Segments

Number of abnormal finding segment

Validity of each diagnostic methods

Pearson correlation ratio and P-value of each diagnostic methods

sensory motor EMG MRI OP

Sensory 1 0.464p<0.01

0.435p<0.01

0.3590.002

0.2650.027

Motor 1 0.1740.019

0.391p<0.01

0.372p<0.01

EMG 1 0.293p<0.01

0.300p<0.01

MRI 1 0.766p<0.01

OP 1

MRI was most validated diagnostic study in

determining the operation levels of cervical

polyradiculopahy.

Clinical application of EMG should be make

a caution due to the low validity than

physical findings.

CONCLUSION