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L4-5, L5-S1 Herniation w/sciatica
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L4-5, L5-S1 Herniation w/sciatica


  I've had two sets of MRIs shot which indicate DDD at L4-5 and L5-S1.  One set was poor in quality and couldn't "absolutly positively" confirm nerve root compression.  The second set detected significant intrusion into the left neuroforamen at the L4-5 level.  This, according to my doctor, explains the pain down my left leg.  According to him, the pain I've been feeling is consistant with sciatic neuropathy at this disk level.  The L5-S1 disk is widely diffused and doesn't appear to be compressing on the nerve root as severely.  I'm in the Army and my new attending physician has scheduled an EMG and nerve conduction velocity test.  Now my question.  Are these test necessary?  From what I have been told (including the DR) that the nerve conduction test can be very painful.  In addition, I've had a lot of people tell me that the tests aren't very good at diagnosing sciatica.  I have a friend with MS and she told me that she thought that the EMG was a neuromuscular test for MS.  I asked my new doctor about this and the NCVT, he told me that generally the tests are only as good as the technician running the exam.  And that there is a good chance the tests will further confirm my leg pain.  Any how I would like some advice.  I have two questions:
  1.) I thought that my MRI confirmed my pain.  Are these tests not good for diagnosing nerve root involvement?
  2.) Are EMGs and NCVTs useful in diagnosing sciatica?
  I'll take the tests anyway I just want to know what I should expect.  Thank you for your input.
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Dear Mike,
An EMG is an electrophysiological test that evaluates the integrity of the nerves and mucular response to stimulation.  This is simply a way to measure the functional status of the nerves and the response of the muscles to stimulation. The MRI will show anatomically that there is a disc
pressing on the nerves, and the EMG will show the effects of the nerve compression in an abnormal response.  The EMG would therefore serve as supportive evidence that the disc is causing significant compression on the nerve(s).
Good luck with the test.







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