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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