OBJECTIVE: The usefulness of electrodiagnostic testing by the primary care provider is shown in two cases of suspected compression-type neural lesions of the lumbar spine.
CLINICAL FEATURES: A 54-yr-old female with acute lumbar spine pain that radiated into the hip and a 26-yr-old male with sharp gluteal pain that radiated into the thigh and ankle were admitted into an inpatient care facility for intensive therapy. Plain film radiographs were obtained initially. In addition, electrodiagnostic testing was performed to evaluate the L5 and S1 nerve roots, which suggested compressive-type lesions. Non-enhanced CT of the lumbar spine was performed and revealed central disk herniation or protrusion in each case.
INTERVENTION AND OUTCOME: One patient exhibiting central compression signs of bladder dysfunction was referred for medical intervention. The remaining patient received flexion-distraction type of chiropractic manipulation with physiologic therapeutics and was discharged to outpatient care after 16 days.
CONCLUSIONS: Electrodiagnostic testing can provide the primary care provider the data needed to make an informed decision regarding advanced imaging studies and to institute appropriate therapy or to intelligently refer a patient for follow-up.
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