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Neurotron, Incorporated Innovative Medical Technology Established 1981 |
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Neurometer® Evaluation of Lumbar/Sacral Radiculopathy |
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Radicular pain can mimic the pain of peripheral neuropathy, peripheral arterial disease or a focal lesion. Sensory impairments resulting from radiculopathy will affect the lower extremity along a dermatomal distribution. Testing the same dermatome at distal and proximal locations (innervated by different nerves, e.g., sites illustrated below: I- Peroneal and J- Saphenous Nerves) or the same peripheral nerve in different dermatomes (e.g., sites I-L4 and H-L5) can help confirm a suspected radiculopathy. The finding of a peripheral sensory impairments measured from several toes, combined with normal CPTs observed at proximal locations within the same dermatome suggests that the lesion involves a peripheral and not a spinal nerve. Spinal lesions or myelopathy will result in a segmental sensory impairment where all dermatomes below the level of the lesion are impaired. There are numerous Neurometer publications describing Lumbar/Sacral radiculopathy associated sensory impairments. (Cutaneous nerve and disc illustration by Frank Netter, MD)
Lumbar, Sacral Radiculopathy Utilization Guidelines Radiculopathic sensory impairments are evaluated by testing two different nerves within the same dermatome or testing the same nerve in two different dermatomes. Unless a distal polyneuropathy is suspected, proximal testing within the same dermatome distribution is unnecessary. When proximal testing conducted on the same nerve additional billing is inappropriate. Lower extremity lumbar/sacral radiculopathy is diagnosed through bilateral sNCT evaluations at sites including the following distal toe/dermatome test sites: medial great toe (L4), dorsal middle toe (L5) and lateral little toe (S1).
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