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Paraspinal Electromyography in High Lumbar and Thoracic Lesions

Haig, Andrew J. MD; Yamakawa, Karen MS; Hudson, Dennis M. MD, PhD

American Journal of Physical Medicine & Rehabilitation: July-August 2000 - Volume 79 - Issue 4 - p 336-342
Research Article: Electromyography

Objective: To use needle electromyography in the paraspinal muscles to localize the root level of a radiculopathy.

Design: We collected nine cases of clinically proven, isolated high lumbar or thoracic disk herniations of patients who underwent MiniPM. Four were from a prospective study of 114 persons with low back pain (MiniPM had 100% sensitivity to magnetic resonance imaging-documented high disks).

Results: In the most medial "S" column, mean MiniPM scores were 0.7 for the level above the radiologically documented lesion; 3.1 at the lesion; and 1.6, 1.6, and 1.1 at the three spinous processes below the lesion. Similar numbers were obtained in the "M" column (slightly lateral), with no significant differences between S and M. Differences were significant between and at the level of the lesion for S (P < 0.06) and M (P < 0.01), and between the lesion level and three levels below for the M column (P < 0.01).

Conclusions: These findings suggest that paraspinal electromyography has a higher than previously reported sensitivity for high lumbar lesions. Electromyography using MiniPM can localize some radiculopathies. The individual cases suggest that, consistent with the anatomy of the caudi equina, thoracic lesions and lateral lumbar lesions denervate only at one level, but more central lumbar lesions also denervate distally innervated paraspinal muscles.

From the Departments of Rehabilitation Medicine and Surgery (AJH, KY), University of Michigan, Ann Arbor, Michigan; and Rehabilitation Associates of Green Bay (DMH), Green Bay, Wisconsin.

Reprints: All correspondence should be addressed to Andrew J. Haig, MD, University of Michigan Medical Center, Physical Medicine & Rehabilitation, 325 E. Eisenhower, 2nd Level, Ann Arbor, MI 48108.

© 2000 Lippincott Williams & Wilkins, Inc.