Affiliation:
1. Haig Physical Medicine PLC Middlebury Vermont USA
2. The University of Michigan Ann Arbor Michigan USA
3. University of Vermont Burlington Vermont USA
Abstract
AbstractParaspinal electromyography has proven to be the most sensitive component of the electrodiagnostic examination for lumbar spinal disorders. However, no standardized, anatomically validated technique has been proposed for the cervical region. This study reviewed the published textbooks on cervical paraspinal anatomy to develop a standardized electromyography technique and scoring system. A library search found 32 anatomy texts published between 2000 and 2021. Of these 11 were unique and appropriate. Most texts described the basic muscle anatomy similarly, but only one cited original research. When the spinous process is defined as the origin, the multifidus and deeper rotatores appear innervated by the posterior primary rami of single cervical roots. However, texts differ in the number of pennae, between two and five, traveling to transverse process regions below. These are crowded into a small area between the spinous processes and transverse processes. Based on this understanding, a proposed cervical paraspinal mapping technique involves skin insertions from 1 to 2 cm lateral to the C5, C7, and T2 spinous processes. The needle samples transversely and deep toward midline, contacts bone, then is withdrawn and redirected to sample medial and caudally to midline to bone, creating two scores of 0–4 at three levels, theoretically resulting in scores of 0–24. This technique must be validated by clinical research to determine the range of normal, reproducibility, and the spectrum of findings in various disorders.
Subject
Neurology (clinical),Neurology,Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation
Reference41 articles.
1. Practice parameter for needle electromyographic evaluation of patients with suspected cervical radiculopathy: summary statement;American Association of Electrodiagnostic Medicine and American Academy of Physical Medicine and Rehabilitation;Muscle Nerve Suppl,1999
2. The biomechanics of the lumbar multifidus
3. A technique for needle localization in paraspinal muscles with cadaveric confirmation
4. HaigAJ McGuireTJ.A review of electromyography techniques of the cervical paraspinal muscles. Accepted PM&R2023.