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Symmetry of paraspinal muscle denervation in clinical lumbar spinal stenosis: Support for a hypothesis of posterior primary ramus stretching?
Article first published online: 28 JUN 2013
© 2013 Wiley Periodicals, Inc.
Muscle & Nerve
Volume 48, Issue 2, pages 198–203, August 2013
How to Cite
Haig, A. J., London, Z. and Sandella, D. E. (2013), Symmetry of paraspinal muscle denervation in clinical lumbar spinal stenosis: Support for a hypothesis of posterior primary ramus stretching?. Muscle Nerve, 48: 198–203. doi: 10.1002/mus.23750
- Issue published online: 23 JUL 2013
- Article first published online: 28 JUN 2013
- Accepted manuscript online: 12 DEC 2012 05:13AM EST
- Manuscript Accepted: 4 DEC 2012
- Manuscript Revised: 30 SEP 2012
- Manuscript Received: 19 OCT 2011
- Eunice Kennedy Shriver National Institute of Child Health & Human Development. Grant Number: R01HD059259
- back pain;
- paraspinal mapping;
- segmental instability;
- spinal stenosis
Denervation of the paraspinal muscles in spinal disorders is frequently attributed to radiculopathy. Therefore, patients with lumbar spinal stenosis causing asymmetrical symptoms should have asymmetrical paraspinal denervation.
Seventy-three patients with clinical lumbar spinal stenosis, aged 55–85 years, completed a pain drawing and underwent masked electrodiagnostic testing, including bilateral paraspinal mapping and testing of 6 muscles on the most symptomatic (or randomly chosen) limb.
With the exception of 10 subjects with unilateral thigh pain (P = 0.043), there was no relationship between side of pain and paraspinal mapping score for any subgroups (symmetrical pain, pain into 1 calf only). Among those with positive limb EMG (tested on 1 side), no relationship between side of pain and paraspinal EMG score was found.
Evidence suggests that paraspinal denervation in spinal stenosis may not be due to radiculopathy, but rather due to stretch or damage to the posterior primary ramus. Muscle Nerve, 48: 198–203, 2013