Usefulness of Diagnostic Tools in Determining the Operation Level in Multi-level Cervical Radiculopathy: Comparison between Physical Findings, MRI, and EMG / 대한정형외과학회잡지

ABSTRACT

PURPOSE: The purpose of this study was to verify the usefulness of each diagnostic tool by comparing physical examination, MRI, and EMG findings with operative findings in multilevel cervical radiculopathy. MATERIALS AND METHODS: Thirty-six (n=36) multilevel cervical radiculopathy patients with a total of 180 levels were included in this study. The findings of preoperative diagnostic tests, including physical examination, EMG and MRI, were analyzed for sensitivity, specificity, positive predictive value and negative predictive value by comparing with the operative findings, which was regarded as the gold standard. Correlation between each diagnostic tools were also analyzed. RESULTS: The sensitivity, specificity, positive and negative predictive values of each item in sensory deficiency were 37%, 86%, 60%, and 72%, motor weakness 62%, 88%, 78%, and 78%, EMG 47%, 87%, 70%, and 71%, and MRI 91%, 86%, 81%, and 93% respectively. Each element showed statistically significant correlation with each diagnostic modality. Correlation between the operative findings and MRI was highest, at 0.766. CONCLUSION: MRI was the most useful diagnostic modality in multi-level cervical radiculopathy. EMG showed relatively low sensitivity and should be considered in conjunction with its clinical application.