Pain Digest, in press, 1998.

THE CURRENT PERCEPTION THRESHOLD EVALUATION IN RADICULOPATHY: EFFICACY IN DIAGNOSIS AND ASSESSMENT OF TREATMENT RESULTS. 

Mironer, Y.E.¹, Somerville, J.J.²
¹Carolina Center For Advanced Management of Pain, Spartanburg, S.C.
²The Pain Management Clinic of Laredo, TX 

INTRODUCTION"...In this study we investigated the role of CPT evaluation in enhancing diagnostic ability in patients with radiculopathy and its efficacy in measuring response to therapy" 

MATERIALS AND METHODS "From July 1996 to July 1997 thirty patients were treated for radicular syndrome using epidural steroid injections (ESI), selective nerve root block (SNRB) and epidural lysis of adhesions (ELA). Patients ranged in age from 30 to 74 years and were nearly equal in gender representation (13 women and 17 men). Eighteen patients had bulging or herniated disc, while twelve suffered from postlaminectomy syndrome. The duration of the disease was from seven months to several years"...

"...the CPT evaluation was performed in three frequencies: 5 Hz, 250 Hz and 2000 Hz, using the Neurometer® CPT/C device." 

RESULTS "The results of the CPT evaluation prior to treatment showed moderate to severe changes in 80% of the patients; six patients had very mild or no changes" 

DISCUSSION "Electrodiagnostic evaluation of patients with radicular syndrome is a standard approach. The use of EMG nerve conduction studies and sensory evoked potentials can help to establish a more precise diagnosis. Unfortunately, they all have their limitations due to different reasons, i.e. cases of Jack involvement of motor roots, cases of sensory axonal degeneration proximal to the sensory root ganglia, cases of involvement of only small-fiber nerves, etc. CPT evaluation of sensoryconfirmed nerve function seems to be an ideal instrument in these patients, since it's ability to quantitatively assess the status of A-beta, A-delta and C fibers has been proved. We confirmed its efficacy to a certain extent, showing 80% positive results in patients with clinical radiculopathy"