Electromyography and Nerve Conduction Studies in Patients with Lumbar SpinalStenosis: Is Neurophysiological Examination an Important Tool?

Background: There is no single test that defines properly lumbar spinal stenosis (LSS) diagnosis, and diagnosis of the syndrome continues to rely on clinical judgment. LSS symptoms may be broad and may be seen in multiple disorders in elderly. Hypothesis: To identify the role of electromyography and nerve-conduction studies on LSS diagnosis. Materials and Methods: A cross-sectional study with prospective data collection was conducted. 31 symptomatic patients with LSS confirmed by MRI were evaluated with neurophysiology tests. We compared symptoms and neurophysiologic findings. Results: All patients reported pain, 83.9% of patients reported it to be moderate or severe and 90% of patients took pain medication. LSS did not affect NCS or SSR. Electromyography confirmed high frequency of radiculopathy, particularly multiradiculopathy. L5 and S1 roots were the most susceptible to injuries. We also found a higher prevalence of L4 radiculopathy. Discussion: Correlating electromyography with clinical findings, we found that the clinical presentation, the most important starting point of an evaluation, is poor in terms of identifying radiculopathy, a frequent consequence of LSS. For this reason, we suggest that electromyography may play an important role as a diagnostic tool, being useful in determining when symptoms are neurogenic in nature. In addition, it may serve to focus treatment only in the area where it is really necessary