Clinical examination versus routine and paraspinal electromyographic studies in predicting the site of lesion in brachial plexus injury ¹

Abstract 

Purpose

To study the role of clinical examination, routine electromyography (EMG), and paraspinal EMG individually and in combination to predict the site of lesion in brachial plexus injury.

Methods

Forty cases of brachial plexus injury were evaluated clinically. They then were subjected to routine and paraspinal EMG. All of them underwent surgical exploration and the intraoperative findings were correlated.

Results

The combination of clinical examination, routine EMG, and paraspinal EMG was able to localize the site of the lesion in 80% of patients in both intra- and extraforaminal injury and in 67% in those with a combination type of lesion. The individual parameter predictability was less; paraspinal EMG had the highest individual predictability (67%).

Conclusions

EMG of the paraspinal muscles helps differentiate between root avulsion and distal rupture. It is useful in the planning for surgery, especially when the lesions are evaluated in combination with clinical examination and routine EMG.

Keywords:  Brachial plexus, injury, paraspinal electromyography

• 1 No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.