Paraspinal muscle fibrillations in "normal" subjects

Journal/Book: Phys Rehab Kur Med 9 (1999) S. M29 / Rehab in Review Vol. 6 Nr.10 1998. 1999 / 1998;

Abstract: Nardin RA et al.: Fibrillations in Lumbosacral Paraspinal Muscles of Normal Subjects. Muscle Nerve 21 (October 1998)1347-1349 Studies of radiculopathy rely heavily on the findings of spontaneous activity (fibrillation and positive sharp waves [PSW]) in the limb and lumbosacral paraspinal muscles. It is not uncommon to identify spontaneous activity exclusively in the lumbar paraspinal muscles. This article sought to determine the frequency of this activity in normal healthy individuals. Lumbosacral paraspinal electromyography was performed in 65 healthy subjects ranging in age from 20 to 88 years. All had normal neurologic examinations. Concentric needle electrodes were inserted into the paraspinal muscles at the L4 and S1 vertebral levels using standardized techniques. All subjects completed the entire electromyographic study. The results revealed that 27 subjects (41.5%) had fibrillations and/or PSW at either one or both levels. Of those with abnormal activity 7.4% had abnormalities at L 4 only 7.4 % at S 1 only and 85 % at both levels. While the abnormal activity was generally characterized as mild the abnormalities were present at four or more insertion points in 78% of the subjects. A positive correlation was found between increasing age and abnormal spontaneous activity (r=0.83 p = 0.04). Conclusion: This study of 65 healthy individuals reveals that over 40% demonstrate abnormal spontaneous activity on EMG. These findings illustrate that isolated findings in the lumbosacral paraspinal muscles are nonspecific and may not be helpful in isolation when diagnosing radiculopathy. ___MH

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