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European Spine Journal

, Volume 27, Issue 8, pp 1734–1743 | Cite as

F-waves of peroneal and tibial nerves in the differential diagnosis and follow-up evaluation of L5 and S1 radiculopathies

  • Chaojun Zheng
  • Jingjuan Liang
  • Cong Nie
  • Yu Zhu
  • Feizhou Lu
  • Jianyuan Jiang
Original Article

Abstract

Purpose

To investigate F-wave as a method to identify a specific root lesion of L5 or S1 and to quantitatively evaluate the severity and progression of motor root lesions in lumbosacral radiculopathies (LR).

Methods

Both peroneal and tibial F-waves were performed bilaterally in 142 patients with unilateral L5 or S1 radiculopathies and 37 controls along with Medical Research Council (MRC) evaluation, and soleus H-reflexes were tested bilaterally in 78 of these 142 cases. Both F-wave and MRC were re-evaluated approximately 1 year after initial examination in 65 patients.

Results

Abnormal peroneal F-waves were found in 34 patients with L5 radiculopathy (34/67, 50.7%) along with normal tibial F-waves and soleus H-reflexes in all tested cases. By contrast, 27 patients with S1 radiculopathy presented abnormal tibial F-waves (27/76, 36.0%) along with normal peroneal F-waves in all 76 cases and abnormal soleus H-reflexes in 38 of 47 (80.9%) cases. There were significant differences in involved side F-duration among different MRC scales in both radiculopathy groups (P < 0.05). Follow-up analysis demonstrated slow progression of both F-wave abnormalities and muscle weakness in patients undergoing conservative treatment (P < 0.05).

Conclusions

Comparisons of F-waves between the same nerve on both sides and between peroneal and tibial nerves in the same leg may clearly increase the validity of F-waves for evaluating a specific motor root lesion of L5 or S1. Furthermore, a quantitative comparison of F-waves may provide additional information on the severity of individual root lesions and their progression even in the early stages of disease.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

F-wave Differential diagnosis Quantitative assessment Lumbosacral radiculopathy 

Notes

Acknowledgments

Financial support from Shanghai City Health System of the Second Batch of Important Diseases Combined Project (2014ZYJ0008), Research project of Shanghai Health Planning Committee (201540236) and Scientific Research project supported by Huashan Hospital, Fudan University (2016QD074) is gratefully acknowledged.

Compliance with ethical standards

Conflict of interest

None of the authors have potential conflicts of interest to be disclosed. The authors alone are responsible for the content and writing of this paper.

Supplementary material

586_2018_5650_MOESM1_ESM.docx (23 kb)
Supplementary material 1 (DOCX 23 kb)
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Supplementary material 2 (DOCX 21 kb)
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Supplementary material 3 (DOC 34 kb)
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Supplementary material 4 (DOCX 19 kb)
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Supplementary material 5 (DOCX 19 kb)
586_2018_5650_MOESM6_ESM.pptx (597 kb)
Supplementary material 6 (PPTX 597 kb)

References

  1. 1.
    Fisher MA (1985) F-waves. Muscle Nerve 8:71–73CrossRefPubMedGoogle Scholar
  2. 2.
    Pan H, Lin J, Chen N et al (2013) Normative data of F-wave measures in China. Clin Neurophysiol 124:183–189CrossRefPubMedGoogle Scholar
  3. 3.
    Koçer A, Gözke E, Dörtcan N et al (2005) A comparison of F waves in peripheral nerve disorders. Electromyogr Clin Neurophysiol 45:417–423PubMedGoogle Scholar
  4. 4.
    Lo YL, Chan LL, Leoh T et al (2008) Diagnostic utility of F waves in cervical radiculopathy: electrophysiological and magnetic resonance imaging correlation. Clin Neurol Neurosurg 110:58–61CrossRefPubMedGoogle Scholar
  5. 5.
    Pastore-Olmedo C, González O, Geijo-Barrientos E (2009) A study of F-waves in patients with unilateral lumbosacral radiculopathy. Eur J Neurol 16:1233–1239CrossRefPubMedGoogle Scholar
  6. 6.
    Mondelli M, Aretini A, Arrigucci U et al (2013) Clinical findings and electrodiagnostic testing in 108 consecutive cases of lumbosacral radiculopathy due to herniated disc. Neurophysiol Clin 43:205–215CrossRefPubMedGoogle Scholar
  7. 7.
    Toyokura M, Furukawa T (2002) F wave duration in mild S1 radiculopathy: comparison between the affected and unaffected sides. Clin Neurophysiol 113:1231–1235CrossRefPubMedGoogle Scholar
  8. 8.
    Gencer M, Uluc K, Cetinkaya Y et al (2011) Clinical utility of F wave parameters in unilateral S1 radiculopathy. Neurosciences (Riyadh) 16:237–241Google Scholar
  9. 9.
    Wilbourn AJ, Aminoff MJ (1998) AAEM minimonograph 32: the electrodiagnostic examination in patients with radiculopathies. American Association of Electrodiagnostic Medicine. Muscle Nerve 21:1612–1631CrossRefPubMedGoogle Scholar
  10. 10.
    Fisher MA (2007) F-waves–physiology and clinical uses. Sci World J 7:144–160CrossRefGoogle Scholar
  11. 11.
    Zheng CJ, Zhu Y, Jin X et al (2014) Potential advantages of the H-reflex of the biceps femoris-long head in documenting S1 radiculopathy. J Clin Neurophysiol 31:41–47CrossRefPubMedGoogle Scholar
  12. 12.
    Zheng C, Zhu Y, Jiang J et al (2016) The prevalence of tarsal tunnel syndrome in patients with lumbosacral radiculopathy. Eur Spine J 25:895–905CrossRefPubMedGoogle Scholar
  13. 13.
    Kimura J (2006) Peripheral Nerve Diseases. Elsevier Health Sciences, New YorkGoogle Scholar
  14. 14.
    Zheng C, Zhu Y, Yang S et al (2016) A study of dynamic F-waves in juvenile spinal muscular atrophy of the distal upper extremity (Hirayama disease). J Neurol Sci 367:298–304CrossRefPubMedGoogle Scholar
  15. 15.
    Zheng C, Zhu Y, Lu F et al (2013) Diagnostic advantage of S1 foramen-evoked H-reflex for S1 radiculopathy in patients with diabetes mellitus. Int J Neurosci 123:770–775CrossRefPubMedGoogle Scholar
  16. 16.
    Fairbank JC, Pynsent PB (2000) The Oswestry disability index. Spine 25:2940–2952CrossRefPubMedGoogle Scholar
  17. 17.
    Toyokura M (1998) F-wave-duration in diabetic polyneuropathy. Muscle Nerve 21:246–249CrossRefPubMedGoogle Scholar
  18. 18.
    Ghugare BW, Singh RK, Patond KR et al (2013) Assessment of nerve conduction study to establish most common electrophysiological predictor of lumbosacral radiculopathy among radiologically diagnosed L5S1 neural foramina compression cases. Indian J Physiol Pharmacol 57:209–213PubMedGoogle Scholar
  19. 19.
    Bromberg MB, Brownell AA (2008) Motor unit number estimation in the assessment of performance and function in motor neuron disease. Phys Med Rehabil Clin N Am 19:509–532CrossRefPubMedGoogle Scholar
  20. 20.
    Zheng C, Zhu Y, Zhu D et al (2017) Motor unit number estimation in the quantitative assessment of severity and progression of motor unit loss in Hirayama disease. Clin Neurophysiol 128:1008–1014CrossRefPubMedGoogle Scholar
  21. 21.
    Murohashi T, Yoshimoto M, Takebayashi T et al (2017) Efficacy of intraoperative direct electrical stimulation of the spinal root and measurement of distal motor latency in lumbar spinal stenosis. Eur Spine J 26:434–440CrossRefPubMedGoogle Scholar
  22. 22.
    Panayiotopoulos CP, Scarpalezos S, Nastas PE (1977) F-wave studies on the deep peroneal nerve. Part 1. Control subjects. J Neurol Sci 31:319–329CrossRefPubMedGoogle Scholar
  23. 23.
    Guiloff RJ, Modarres-Sadeghi H (1991) Preferential generation of recurrent responses by groups of motor neurons in man. Conventional and single unit F wave studies. Brain 114:1771–1801CrossRefPubMedGoogle Scholar
  24. 24.
    Chroni E, Tendero IS, Punga AR et al (2012) Usefulness of assessing repeater F-waves in routine studies. Muscle Nerve 45:477–485CrossRefPubMedGoogle Scholar
  25. 25.
    Mebrahtu S, Rubin M (1993) The utility of F wave chronodispersion in lumbosacral radiculopathy. J Neurol 240:427–429CrossRefPubMedGoogle Scholar
  26. 26.
    Galamb AM, Minea ID (2015) Late responses in the electrodiagnosis of cervical radiculopathies. Clujul Med 88:44–49CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopedics, Huashan HospitalFudan UniversityShanghaiChina
  2. 2.Department of Physical Medicine and RehabilitationUpstate Medical University, State University of New York at SyracuseSyracuseUSA
  3. 3.Department of Orthopedics, The Fifth People’s HospitalFudan UniversityShanghaiChina

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