The role of electrophysiology in the diagnosis of radiculopathy and its comparison with magnetic resonance imaging

Abstract

Objectives: Patients are frequently referred to electrophysiology laboratories by physicians from various specialties with a presumptive diagnosis of radiculopathy. Recent advances in spinal imaging techniques have led to an increase in magnetic resonance imaging (MRI) studies in the diagnosis of radiculopathy. This study aimed to compare these two techniques in the diagnosis of radiculopathy. Subjects and Methods: Data of 170 patients who were diagnosed as having radiculopathy using electrophysiologic studies in our laboratory by defining a myotome level and who had spinal MRI examinations in our hospital database were included in the study. Results: Among the 170 patients in our study, 40% (n = 68) had cervical radiculopathy and 60% (n = 102) had lumbar radiculopathy. In the electrophysiologic diagnosis of radiculopathy, the most sensitive root level of electromyography (EMG) was the C7 radix level in the cervical region and the L5 level in the lumbar region. Correlations between radiologic grading based on foraminal assessments for radicular involvement at the cervical region using MRI and EMG data showed fair agreement in C5, C7, and C8 radix levels (κ: 0.21–0.40), and the lumbar region showed fair agreement in L4 and L5 radix levels (κ: 0.21–0.40). Conclusion: Although EMG has indisputable importance in the diagnosis of radiculopathy, its use with MRI significantly increases the diagnostic power at most spinal levels.