Andrew J Haig1, Zachary London, Danielle E Sandella. 1. Department of Physical Medicine and Rehabilitation, University of Michigan, 325 East Eisenhower, Ann Arbor, Michigan 48108, USA. andyhaig@umich.edu
Abstract
INTRODUCTION: Denervation of the paraspinal muscles in spinal disorders is frequently attributed to radiculopathy. Therefore, patients with lumbar spinal stenosis causing asymmetrical symptoms should have asymmetrical paraspinal denervation. METHODS:Seventy-three patients with clinical lumbar spinal stenosis, aged 55-85 years, completed a pain drawing and underwent masked electrodiagnostic testing, including bilateral paraspinal mapping and testing of 6 muscles on the most symptomatic (or randomly chosen) limb. RESULTS: With the exception of 10 subjects with unilateral thigh pain (P = 0.043), there was no relationship between side of pain and paraspinal mapping score for any subgroups (symmetrical pain, pain into 1 calf only). Among those with positive limb EMG (tested on 1 side), no relationship between side of pain and paraspinal EMG score was found. CONCLUSION: Evidence suggests that paraspinal denervation in spinal stenosis may not be due to radiculopathy, but rather due to stretch or damage to the posterior primary ramus.
RCT Entities:
INTRODUCTION: Denervation of the paraspinal muscles in spinal disorders is frequently attributed to radiculopathy. Therefore, patients with lumbar spinal stenosis causing asymmetrical symptoms should have asymmetrical paraspinal denervation. METHODS: Seventy-three patients with clinical lumbar spinal stenosis, aged 55-85 years, completed a pain drawing and underwent masked electrodiagnostic testing, including bilateral paraspinal mapping and testing of 6 muscles on the most symptomatic (or randomly chosen) limb. RESULTS: With the exception of 10 subjects with unilateral thigh pain (P = 0.043), there was no relationship between side of pain and paraspinal mapping score for any subgroups (symmetrical pain, pain into 1 calf only). Among those with positive limb EMG (tested on 1 side), no relationship between side of pain and paraspinal EMG score was found. CONCLUSION: Evidence suggests that paraspinal denervation in spinal stenosis may not be due to radiculopathy, but rather due to stretch or damage to the posterior primary ramus.
Authors: James N Weinstein; Tor D Tosteson; Jon D Lurie; Anna Tosteson; Emily Blood; Harry Herkowitz; Frank Cammisa; Todd Albert; Scott D Boden; Alan Hilibrand; Harley Goldberg; Sigurd Berven; Howard An Journal: Spine (Phila Pa 1976) Date: 2010-06-15 Impact factor: 3.468
Authors: Andrew J Haig; Henry C Tong; Karen S J Yamakawa; Christopher Parres; Douglas J Quint; Anthony Chiodo; Jennifer A Miner; Vaishali C Phalke; Julian T Hoff; Michael E Geisser Journal: Spine (Phila Pa 1976) Date: 2006-12-01 Impact factor: 3.468
Authors: Leonid Kalichman; Robert Cole; David H Kim; Ling Li; Pradeep Suri; Ali Guermazi; David J Hunter Journal: Spine J Date: 2009-04-23 Impact factor: 4.166
Authors: Johann Steurer; Alexander Nydegger; Ulrike Held; Florian Brunner; Jürg Hodler; François Porchet; Kan Min; Anne F Mannion; Beat Michel Journal: BMC Musculoskelet Disord Date: 2010-11-02 Impact factor: 2.362
Authors: R J Crawford; L Filli; J M Elliott; D Nanz; M A Fischer; M Marcon; E J Ulbrich Journal: AJNR Am J Neuroradiol Date: 2015-12-03 Impact factor: 3.825