Predictability of Adequacy of Spinal Root Decompression Using Evoked Potentials

Cohen, Bernard A.; Major, Michael R.; Huizenga, Bernard A.

doi:10.1097/00007632-199108001-00015

Cited by 36 publications

(3 citation statements)

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“…5,6 Scientists have investigated the use of MMG as an assessment of surgical nerve decompression in patients with entrapment, particularly in the lumbar spine surgery literature. In a study conducted by Cohen et al, 7 nerve root decompression was evaluated in 12 patients with sciatica and motor weakness. Dermatomalevoked potentials were monitored preoperatively, intraoperatively, and postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Incorporating Intraoperative Mechanomyography to Peripheral Nerve Decompression Surgery

Guerrero

Taghlabi

Bhenderu

et al. 2023

Operative Neurosurgery

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BACKGROUND: Mechanomyography (MMG) is a novel intraoperative tool to detect and quantify nerve activity with high sensitivity as compared with traditional electromyographic recordings. MMG reflects the mechanical vibrations of single motor units detected through accelerometer sensors after direct motor neuron stimulation. OBJECTIVE: To determine the feasibility of applying intraoperative MMG during peripheral nerve surgery. METHODS: A total of 20 consecutive patients undergoing surgical decompression of the ulnar nerve at the cubital tunnel or common peroneal nerve at the fibular head were included in this study. Intraoperatively, the common peroneal and ulnar nerves were directly stimulated through the MMG electrode probe starting at 0.1 mA threshold and increasing by 0.1 mA increments until target muscle activity was noted. The lowest threshold current required to elicit a muscle response was recorded before decompression and after proximal and distal nerve decompression. RESULTS: Of the patients, 80% (16/20) had MMG signals detected and recorded. Four patients were unable to have MMG signal detected despite direct nerve visualization and complete neurolysis. The mean predecompression stimulus threshold was 1.59 ± 0.19 mA. After surgical decompression, improvement in the mean MMG stimulus threshold was noted (0.47 ± 0.03 mA, P = .0002). Postoperatively, all patients endorsed symptomatic improvement with no complications. CONCLUSION: MMG may provide objective guidance for the intraoperative determination of the extent of nerve decompression. Lower stimulus thresholds may represent increased sparing of axonal tissue. Future work should focus on validating normative values of MMG stimulus thresholds in various nerves and establishing clinical associations with functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Incorporating Intraoperative Mechanomyography to Peripheral Nerve Decompression Surgery

Guerrero

Taghlabi

Bhenderu

et al. 2023

Operative Neurosurgery

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“…Cohen, et al, 7 retrospectively reviewed a very select group of 12 patients (in a total population of 150) with weakness due to compression of lumbar nerve roots. Nine of the patients had complete normalization of DSEPs following decompression and had improved strength postoperatively.…”

Section: Monitoring During Decompressionmentioning

confidence: 99%

Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 15: electrophysiological monitoring and lumbar fusion

Resnick¹,

Choudhri²,

Dailey³

et al. 2005

Journal of Neurosurgery: Spine

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“…45 Instead, Owen,46 in another study conducted on 230 patients, noticed that the relationship between the improvement of DSEPs and adequacy of decompression was also a ected by the duration of nerve root compression: if this is acute, it is not unusual to observe an improvement of DSEPs after surgical decompression; on the other hand, it does not appear that DESPs provide information regarding adequacy of nerve root decompression in patients with chronic root compression. In a recent study on 33 patients Tsai 47 found a DSEPs improvement on latency, amplitude and morphology, but the surgical outcome was good in only 13 patients (39.4%), concluding that improvement indicated by DSEPs improvement does not coincide with good clinical outcome.…”

Section: Monitoring Root Functionmentioning

confidence: 99%

Intra-operative spinal cord monitoring in orthopaedics

Macri¹,

Monte²,

Greggi³

et al. 2000

Spinal Cord

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The surgical correction of spinal deformities carries a small but signi®cant risk of injury to the spinal cord. To detect the onset and possibly reverse the e ects of surgical complication, a variety of neurophysiological monitoring procedures can be employed. The purpose of this review is to provide information regarding the various methodologies available for monitoring spinal cord and nerve root function during orthopaedic procedures. Intra-operative monitoring of cortically recorded somatosensory evoked potentials (SEPs) by peripheral nerve stimulation is of value during orthopaedic surgery and is the state-of-the-art in terms of non-invasiveness, versatility, time requirement, lateral discrimination, and ease of electrode placement. Monitoring of motor evoked potentials (MEPs) is useful particularly in combination with SEPs but is still considered investigational. Root function monitoring has limited application and requires more clinical research. Spinal Cord (2000) 38, 133 ± 139

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Predictability of Adequacy of Spinal Root Decompression Using Evoked Potentials

Cited by 36 publications

References 0 publications

Incorporating Intraoperative Mechanomyography to Peripheral Nerve Decompression Surgery

Incorporating Intraoperative Mechanomyography to Peripheral Nerve Decompression Surgery

Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 15: electrophysiological monitoring and lumbar fusion

Intra-operative spinal cord monitoring in orthopaedics

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