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Electrodiagnostic studies are performed especially in spinal stenosis because it helps the clinician to exactly localize and rule out other differentials. There are two main parts to an electrodiagnostic study, they include the nerve conduction study and the needle electromyography study. This activity reviews the electrodiagnostic findings associated with spinal stenosis and highlights the role of the interprofessional team in evaluating and treating this condition. Objectives: Describe the pathophysiology of spinal stenosis. Identify the indications for electrodiagnostic studies in spinal stenosis. Summarize the risks and contraindications associated with electrodiagnostic studies for a patient with spinal stenosis. Describe the typical electrodiagnostic study findings associated with spinal stenosis. Access free multiple choice questions on this topic.

Spinal stenosis refers to a narrowing of the vertebral canal, which can occur at any level. The narrowing can compress on nerve tissue that travels through the spine and cause pain, often in the lower back or neck. Spinal stenosis most commonly occurs in the lumbar spine than the cervical spine. Studies have reported an incidence of 1 in 100 000 for cervical spine stenosis and 5 in 100 000 for lumbar spine stenosis.[1] Spinal stenosis can lead to impingement of the spinal cord, cauda equina, and/or nerve roots. Spinal stenosis is most frequently acquired and, therefore, often seen in the geriatric population though it can also be congenital. In clinical practice, the physician will encounter patients who complain of pain, numbness, or weakness. If it involves the cervical spine, the patient will complain of neck pain that radiates to one or both of their upper extremities. If the patient is coming with lumbar stenosis, they will complain of dull achy pain in the legs, calves, thighs, and buttocks area. They may report that the pain is worse with standing or walking for prolonged periods and relieved with sitting. The reason for this is that during sitting, the diameter of the spinal canal increases because of the flexion that occurs. Often spinal stenosis is associated with neurologic claudication; this refers to the intermittent compression of the lumbar nerve roots resulting in sporadic leg pain.[2] Cervical stenosis can also progress to myelopathy. This condition refers to compression on the spinal cord that is often associated with clumsiness in hands and gait imbalance.[1]

As with all electrodiagnostic studies in any setting and for any indication- the risk of complications is low. There is always a small risk of bleeding or introducing infection with needle studies.[9]

Lumbar spinal stenosis is a condition often seen in the outpatient setting. Patients frequently come with complaints of pain and/or paresthesias in the extremities. Imaging studies, in addition to electrodiagnostic studies, are routinely ordered. Physicians must be cautious, as imaging findings might not correlate with the patient's symptoms. It is essential to take an interprofessional team including a team of physicians (physical medicine and rehabilitation, pain management, orthopedist, and/or neurosurgeons), physical therapists, occupational therapist, social workers, and case managers who can work together to coordinate mobilization with outpatient therapy and aggressive multifaceted rehabilitation so we can improve a patient's functional status. Typically there is a long and challenging recovery ahead for patients with spinal stenosis, but with a coordinated effort between the various medical disciplines and departments, the best outcomes for patients are achievable.[14]