Search for other papers by James B. Talmage in
Current site
Google Scholar
PubMed
Abstract
In assessing spinal impairment, it is imperative to distinguish between limb pain or numbness that might be radicular, but with no objective verification, from symptoms that represent, in fact, true radiculopathy, ie, pain, numbness, or weakness that was related to objective radiculopathy. In the sixth edition of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), this distinction determines what row in the spine tables is used to rate impairment. Failure to discern between nonverifiable radicular complaints and true radiculopathy is a source of frequent errors in spinal impairment rating. True radiculopathy is pain, numbness, and/or weakness from nerve root damage, most commonly from a disc herniation. This article will review how the AMA Guides has dealt with the concept of radiculopathy through the years.
-
1.
Bible JE, Biswas D, Miller CP, et al.Normal functional range of motion of the lumbar spine during 15 activities of daily living. J Spinal Disord Tech. 2010;23(2):106–112. doi: 10.1097/BSD.0b013e3181981823.
-
2.
Swinkels RA, Swinkels-Meewisse IE. Normal values for cervical range of motion. Spine. 2014;39(5):362–367. doi: 10.1097/BRS.0000000000000158.
-
3.
Cobian DG, Daehn NS, Anderson PA, Heiderscheit BC. Active cervical and lumbar range of motion during performance of activities of daily living in healthy young adults. Spine. 2013;38(20):1754–1763. doi: 10.1097/BRS.0b013e3182a2119c.
-
4.
Hartvigsen J, Hancock MJ, Kongsted A, et al; Lancet Low Back Pain Series Working Group. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–2367. doi: 10.1016/S0140-6736(18)30480-X.
-
5.
Matsumoto M, Fujimura Y, Suzuki N, et al. MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg. 1998;80(1):19-24. doi: 10.1302/0301-620X.80B1.0800019.
-
6.
Okada E, Matsumoto M, Ichihara D, et al.Aging of the cervical spine in healthy volunteers: a 10-year longitudinal magnetic resonance imaging study. Spine. 2019;34(7):706–712. doi: 10.1097/BRS.0b013e31819c2003.
-
7.
Daimon K, Fujiwara H, Nishiwaki Y, et al. A 20-year prospective longitudinal study of degeneration of the cervical spine in a volunteer cohort assessed using MRI: follow-up of a cross-sectional study. J Bone Joint Surg. 2018;100(10):843-849. doi: 10.2106/JBJS.17.01347.
-
8.
van den Heuvel MM, Oei E, Bierma-Zeinstra S, et al. The prevalence of abnormalities in the pediatric spine on MRI: a systematic review and meta-analysis. Spine. 2020;45(18):E1185-E1196. doi: 10.1097/BRS.0000000000003527.
-
9.
Brinjikji W, Luetmer PH, Comstock B, et al.Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811–816. doi: 10.3174/ajnr.A4173.
-
10.
Romeo V, Covello M, Salvatore E, et al.High prevalence of spinal magnetic resonance imaging findings in asymptomatic young adults (18-22 yrs) candidate to Air Force flight. Spine. 2019;44(12):872–878. doi: 10.1097/BRS.0000000000002961.
-
11.
Janssen SJ, Teunis T, Ring D, et al.Cognitive biases in orthopaedic surgery. J Am Acad Orthopaed Surg. 2021;29(14):624–633. doi: 10.5435/JAAOS-D-20-00620.
-
12.
Suri P, Hunter DJ, Katz JN, et al. Bias in the physical examination of patients with lumbar radiculopathy. BMC Musculoskelet Disord. 2010;11:275. doi: 10.1186/1471-2474-11-275.
-
13.
McAnany SJ, Rhee JM, Baird EO, et al. Observed patterns of cervical radiculopathy: how often do they differ from a standard, “Netter diagram” distribution? Spine J. 2019;19(7):1137–1142. doi: 10.1016/j.spinee.2018.08.002.
-
14.
Hancock MJ, Koes B, Ostelo R, et al. Diagnostic accuracy of the clinical examination in identifying the level of herniation in patients with sciatica. Spine. 2011;36(11):E712–E719. doi: 10.1097/BRS.0b013e3181ee7f78.
-
15.
Taylor CS, Coxon AJ, Watson PC, et al. Do L5 and S1 nerve root compressions produce radicular pain in a dermatomal pattern? Spine. 2013;38(12):995–998. doi: 10.1097/BRS.0b013e318286b7dd.
-
16.
Netter FH. Netter Atlas of Human Anatomy: Classic Regional Approach, 8th ed. Cambridge, MA: Elsevier; 2022.
-
17.
Fardon DF, Williams AL, Dohring EJ, et al. Lumbar disc nomenclature: version 2.0: recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology, and the American Society of Neuroradiology. Spine. 2014;39(24):E1448–E1465. doi: 10.1097/BRS.0b013e3182a8866d.
-
18.
Tawa N, Rhoda A, Diener I. Accuracy of magnetic resonance imaging in detecting lumbo-sacral nerve root compromise: a systematic literature review. BMC Musculoskelet Disord. 2016;17(1):386. doi: 10.1186/s12891-016-1236-z.
-
19.
Chiu CC, Chuang TY, Chang KH, et al.The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015;29(2):184–195. doi: 10.1177/0269215514540919.
-
20.
Finnerup NB, Haroutounian S, Kamerman P, et al.Neuropathic pain: an updated grading system for research and clinical practice. Pain. 2016;157(8):1599–1606. doi: 10.1097/j.pain.0000000000000492.
-
21.
Bonezzi C, Fornasari D, Cricelli C, et al. Not all pain is created equal: basic definitions and diagnostic work-up. Pain Ther. 2020;9(Suppl 1):1–15. doi: 10.1007/s40122-020-00217-w.
-
22.
Talmage JB, Snyder RB. Opioids: current science. AMA Guides Newsletter, 2021;26(5):3–12. doi: 10.1001/amaguidesnewsletters.2021.SeptOct01.
| All Time | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1621 | 1621 | 285 |
| Full Text Views | 51 | 51 | 1 |
| PDF Downloads | 0 | 0 | 0 |
