HSS Journal

, Volume 5, Issue 1, pp 73–77 | Cite as

T1 Radiculopathy: Electrodiagnostic Evaluation

  • Jeffrey Radecki
  • Joseph H. Feinberg
  • Zachary R. Zimmer
Electrodiagnostic Corner

Abstract

Electromyography (EMG) studies are useful in the anatomical localization of nerve injuries and, in most cases, isolating lesions to a single nerve root level. Their utility is important in identifying specific nerve-root-level injuries where surgical or interventional procedures may be warranted. In this case report, an individual presented with right upper extremity radicular symptoms consistent with a clinical diagnosis of cervical radiculopathy. EMG studies revealed that the lesion could be more specifically isolated to the T1 nerve root and, furthermore, provided evidence that the abductor pollicis brevis receives predominantly T1 innervation.

Keywords

electromyography EMG electrodiagnostics T1 radiculopathy abductor pollicis brevis (APB) T1-T2 disc herniation 

References

  1. 1.
    Murphey F, Simmons JC, Brunson B (1973) Surgical treatment of laterally ruptured cervical disc. Review of 648 cases, 1939 to 1972. J Neurosurg 38:679–683PubMedGoogle Scholar
  2. 2.
    Levin KH (2002) Electrodiagnostic approach to the patient with suspected radiculopathy. Neurol. Clin N Am 20:397–421Google Scholar
  3. 3.
    Levin KH, Maggiano HJ, Wilbourn AJ (1996) Cervical radiculopathies: comparison of surgical and EMG localization of single-root lesions. Neurology 46:1022–1025PubMedGoogle Scholar
  4. 4.
    Levin KH (1999) Neurologic manifestations of compressive radiculopathy of the first thoracic root. Neurology. 53:1149–1151PubMedGoogle Scholar
  5. 5.
    Levin KH, Wilbourn AJ, Maggiano HJ (1998) Cervical rib and median sternotomy-related brachial plexopathies: a reassessment. Neurology 50:1407–1413PubMedGoogle Scholar
  6. 6.
    Wilbourn AJ, Ferrante MA (2000) Clinical electromyography. In: Joynt RJ, Griggs RC (eds) Baker’s clinical neurology on CDROM. Lippincott, Williams & Wilkins, Philadelphia, pp 7592–8248. recordGoogle Scholar
  7. 7.
    Wilbourn AJ (1985) Electrodiagnosis of plexopathies. Neuro Clin 3:511–529Google Scholar
  8. 8.
    Ferrante MA, Wilbourn AJ (2002) Electrodiagnostic approach to the patient with suspected brachial plexopathy. Neurol Clin N Am 20:423–450Google Scholar
  9. 9.
    Alberico AM, Sahni KS, Hall JA Jr et al (1986) High thoracic disc herniation. Neurosurgery 19:449–451PubMedCrossRefGoogle Scholar
  10. 10.
    Arce CA, Dohrmann GJ (1985) Herniated thoracic disks. Neurol Clin 3:383–392PubMedGoogle Scholar
  11. 11.
    Singounas EG, Kypriades EM, Kellerman AJ et al (1992) Thoracic disc herniation. Analysis of 14 cases and review of the literature. Acta Neurochir (Wien) 116:49–52CrossRefGoogle Scholar
  12. 12.
    Awwad EE, Martin DS, Smith KR et al (1991) Asymptomatic versus symptomatic herniated thoracic discs: their frequency and characteristics as detected by computed tomography after myelography. Neurosurgery 28:180–186PubMedCrossRefGoogle Scholar
  13. 13.
    Brown CW, Deffer PA Jr, Akmakjian J et al (1992) The natural history of thoracic disc herniation. Spine 17:s97–s102PubMedGoogle Scholar
  14. 14.
    Blumenkopf B (1988) Thoracic intervertebral disc herniations: diagnostic value of magnetic resonance imaging. Neurosurgery 23:36–40PubMedCrossRefGoogle Scholar
  15. 15.
    Tahmouresie A (1980) Herniated thoracic intervertebral disc—an unusual presentation: case report. Neurosurgery 7:623–625PubMedCrossRefGoogle Scholar
  16. 16.
    Videman T, Battié MC, Gill K et al (1995) Magnetic resonance imaging findings and their relationships in the thoracic and lumbar spine. Insights into the etiopathogenesis of spinal degeneration. Spine 20:928–935PubMedCrossRefGoogle Scholar
  17. 17.
    Arce CA, Dohrmann GJ (1985) Thoracic disc herniation. Improved diagnosis with computed tomographic scanning and a review of the literature. Surg Neurol 23:356–361PubMedCrossRefGoogle Scholar
  18. 18.
    O’Connor RC, Andary MT, Russo RB et al (2002) Thoracic radiculopathy. Phys Med Rehabil Clin N Am 13:623–644PubMedGoogle Scholar
  19. 19.
    McInerney J, Ball PA (2000) The pathophysiology of thoracic disc disease. Neurosurg Focus 9:1–8CrossRefGoogle Scholar
  20. 20.
    Stillerman CB, Chen TC, Couldwell WT et al (1988) Experience in the surgical management of 82 symptomatic herniated thoracic discs and review of the literature. J Neurosurg 88:623–633Google Scholar
  21. 21.
    Post NH, Cooper PR, Frempong-Boadu AK et al (2006) Unique features of herniated discs at the cervicothoracic junction: clinical presentation, imaging, operative management, and outcome after anterior decompressive operation in 10 patients. Neurosurgery 58:497–501PubMedGoogle Scholar
  22. 22.
    Parke WW (1982) Biomechanics of the spine. In: Rothman RH, Simeone FA (eds) The Spine, 2nd edn, vol 1. Saunders, Philadelphia, pp 47–49Google Scholar
  23. 23.
    Takagi H, Kawaguchi Y, Kanamori M et al (2002) T1–2 disc herniation following an en bloc cervical laminoplasty. J Ortho Sci 7:495–497CrossRefGoogle Scholar
  24. 24.
    Frecerro D, Donovan DJ (2005) Adjacent segment degeneration at T1–T2 presenting as chest pain: case report. Spine 30:E655–E657CrossRefGoogle Scholar
  25. 25.
    Negoveti L, Cerina V, Sajko T et al (2001) Intradural disc herniation at the T1–T2 level. Croat Med J 42:193–195Google Scholar
  26. 26.
    Nakahara S, Sato T (1995) First thoracic disc herniation with myelopathy. Eur Spine J 4:366–367PubMedCrossRefGoogle Scholar
  27. 27.
    Caner H, Kilinçoglu BF, Benli S et al (2003) Magnetic resonance image findings and surgical considerations in T1–2 disc herniation. Can J Neuro 30:152–154Google Scholar
  28. 28.
    Gelch MM (1978) Herniated thoracic disc at T1–2 level associated with Horner’s syndrome. Case report. J Neurosurg 48:128–129PubMedGoogle Scholar
  29. 29.
    Morgan H, Abood C (1998) Disc herniation at T1–2. Report of four cases and literature review. J Neurosurg 88:148–150PubMedCrossRefGoogle Scholar
  30. 30.
    Lyu RK, Chang HS, Tang LM et al (1999) Thoracic disc herniation mimicking acute lumbar disc disease. Spine 24:416–418PubMedCrossRefGoogle Scholar
  31. 31.
    Lloyd TV, Johnson JC, Paul DJ et al (1980) Horner’s syndrome secondary to herniated disc at T1–T2. Am J Roentgenol 134:184–185Google Scholar

Copyright information

© Hospital for Special Surgery 2008

Authors and Affiliations

  • Jeffrey Radecki
    • 1
  • Joseph H. Feinberg
    • 1
  • Zachary R. Zimmer
    • 1
  1. 1.Department of PhysiatryHospital for Special SurgeryNew YorkUSA

Personalised recommendations