Utility of Direct Stimulation of Roots in Spinal Surgery

Masaaki TAKEDA; Satoshi YAMAGUCHI; Mizuki MORISHIGE; Kuniki EGUCHI; Kaoru KURISU

doi:10.2176/nmc.51.356

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Utility of Direct Stimulation of Roots in Spinal Surgery

Journal article

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Peer reviewed

Utility of Direct Stimulation of Roots in Spinal Surgery

Masaaki TAKEDA, Satoshi YAMAGUCHI, Mizuki MORISHIGE, Kuniki EGUCHI and Kaoru KURISU

Neurologia medico-chirurgica, Vol.51(5), pp.356-360

2011

DOI: 10.2176/nmc.51.356

PMID: 21613760

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Abstract

Prevention of postoperative neurological deficits is a major concern of spinal surgeons and has led to the introduction and current development of intraoperative neurophysiological monitoring. We have used motor evoked potentials and somatosensory evoked potentials as routine monitoring techniques and, in some cases, added optional methods such as direct stimulation of nerve roots and spinal evoked potentials. We report our experience of direct nerve root stimulation as an optional monitoring method during spinal surgeries in 7 patients with lesions affecting the proximal nerve roots aged from 1 day to 78 years (mean 23.5 years). Four patients had anomalous lesions, two had spinal nerve root schwannomas, and one had a far-lateral lumbar disc herniation. Direct stimulation was used for detection of motor nerve roots in the anomalous lesions and schwannomas, and to distinguish the nerve root from the paraspinal soft tissues in the case of a far-lateral herniated disc at the L5-S1 level. Although some patients had slight transient neurological symptoms such as motor weakness and sensory disturbance, none developed severe permanent neurological impairment. Direct stimulation allows detection of the motor nerve during spinal surgery in real time. Our limited experience suggests that the direct stimulation technique could reduce the risk of motor or vesicorectal disturbance after surgery of lesions affecting or involving the spinal nerve roots.

compound muscle action potential

spinal surgery

intraoperative neurophysiological monitoring

spinal nerve root

direct stimulation

Details

Title: Subtitle: Utility of Direct Stimulation of Roots in Spinal Surgery
Creators: Masaaki TAKEDA - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences
Satoshi YAMAGUCHI - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences
Mizuki MORISHIGE - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences
Kuniki EGUCHI - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences
Kaoru KURISU - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences
Resource Type: Journal article
Publication Details: Neurologia medico-chirurgica, Vol.51(5), pp.356-360
DOI: 10.2176/nmc.51.356
PMID: 21613760
NLM abbreviation: Neurol Med Chir (Tokyo)
ISSN: 0470-8105
eISSN: 1349-8029
Publisher: 一般社団法人日本脳神経外科学会
Language: English
Date published: 2011
Academic Unit: Neurosurgery
Record Identifier: 9984040584502771

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