Traumatic myelopathies often present in the emergency department or are diagnosed by history, examination, and MRI without EMG/NCS, which assesses the peripheral nervous system.
Typical injuries with STRS include motor vehicle accidents, sports injuries, slip and falls, and heavy pulling or pushing. This correspondence on the use of outpatient EMG/NCS is limited to cervical and lumbosacral spine trauma with radicular symptoms (STRS) without myelopathy not inflammatory, infectious, or hereditary causes. 1 Using a series of representative cases of patients with spinal, nonmyelopathic trauma, we review the role of EMG/NCS in conjunction with review of the literature in patients referred for outpatient electrodiagnostic studies. Herniated disks (HNP), fractures, spondylolisthesis, and exacerbation of preexisting spondylosis/spondylolisthesis can lead to radicular, referred, or myelopathic findings. Lumbosacral and cervical trauma can cause non-neural axial or referred symptoms due to injuries to the paraspinal muscles, ligaments, sacroiliac and zygapophysial joints, and peripheral disk annulus. History, examination, and imaging are essential elements of the diagnosis and treatment algorithm.
Many referrals to the electrodiagnostic laboratory are for nonmyelopathic traumatic injuries to the spine region causing axial, referred, and radicular signs and symptoms. EMG/nerve conduction studies (NCS) is an extension of the neurologic clinical evaluation focusing on the peripheral nervous system, and recognizing that lesions do not occur in electrodiagnostic isolation, but are to be taken in coordination with a thorough neurologic examination and imaging studies to assess the patient's clinical picture.
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