Validity of diagnostic tools in determining the operation level in multilevel cervical radiculopathy -analysis between physical finding, MRI, and EMG-

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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-

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PURPOSE

• 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.

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Demographic Data
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Physical Examination
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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.

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MRI

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

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Gold Standard

• - Positive confirmed by operation
• - Negative no pathology (in PE, MRI, EMG).
• the segments not included in
  operation

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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.

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RESULTS
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Abnormal finding Segments

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Number of abnormal finding segment
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Validity of each diagnostic methods
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Pearson correlation ratio and P-value of each
diagnostic methods
sensory motor EMG MRI OP
Sensory 1 0.464 plt0.01 0.435 plt0.01 0.359 0.002 0.265 0.027
Motor 1 0.174 0.019 0.391 plt0.01 0.372 plt0.01
EMG 1 0.293 plt0.01 0.300 plt0.01
MRI 1 0.766 plt0.01
OP 1
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CONCLUSION

• 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.