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  • omid
    Participant
    Post count: 3

    Hello dear doctor. I did a new emg and the result were:

    bilateral l2 l3 l4 roots involvement and data for active axonal degeneration in upper parts present studies.

    1-2* fibrillation in lumbosacral paraspinal and iliopsoas musles with polyphasic MUAPs in distal and thigh musles

    What does this result mean? Please guide me.thank you very much

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    I need to know what the images of the lumbar spine convey to help and understand what the potential source of this nerve involvement could be.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    omid
    Participant
    Post count: 3

    Thank you dear doctor for your replying.Doctor I live in another country and I can not send you my mri. I have a question.
    What does “active axonal degeneration in upper parts” mean?
    Please guide me.
    The best

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    You can cut and paste the radiologist report here to allow me to review it.

    Axonal degeneration is the injury to the nerve cells (the axon is the long part of the cell that delivers the messages to and from the part of the body supplied by that particular nerve).

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    omid
    Participant
    Post count: 3

    1. Normal NVVs
    2. Normal latencies
    3. Normal SNAPs
    4. Normal CMAPs
    5. Normal resistances to stimulation
    6. Normal F/M/H bilaterally
    7. 1-2* fibrillation in lumbosacral paraspinal and iliopsoas muscles with polyfasic MUAPs in distal and thighs muscles.

    IMPRESSION:

    Bilateral L2, L3, L4 roots involvement and data for active axonal degeneration in upper parts in presenet studies.

    Doctor I have another question.
    ” axonal degeneration in upper parts” means retrograde degeneration or wallerian degeneration? Are thete any treatmeents for axonal degeneration?
    Thank you a lot

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Fibrillation potentials indicate muscle denervation (loss of nerve supply to the muscle). Since the paraspinal muscles are innervated by the posterior branches of the exiting nerve roots, there had to be some injury to these roots. However, if you ever had radio-frequency ablations for facet pain, the results would look similar.

    Polyphasic MUAPs (motor unit action potentials) can indicate a myopathy (the muscle itself is sick) or a radiculopathy (nerve root compression).

    The nerve when injured and the myelin sheath is still intact will die down the sheath at the point of injury away from the cell body (the spine) in 2-3 weeks which is the time period of nerve injury EMG findings distally. The new growth down the intact sheath takes about 1 inch per month to grow to its target muscle.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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