Open AccessMonitoring of Lumbosacral Nerve Roots During Spinal Instrumentation
Author(s) -
Joseph T. Hormes,
James L. Chappuis
Publication year - 1993
Publication title -
spine (philadelphia, pa. 1976)/spine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.657
H-Index - 254
eISSN - 1528-1159
pISSN - 0362-2436
DOI - 10.1097/00007632-199310001-00023
Subject(s) - medicine , lumbosacral joint , electromyography , cauda equina , nerve root , spinal cord , lumbar , anatomy , compound muscle action potential , dissection (medical) , electrophysiology , physical medicine and rehabilitation , psychiatry
A technique is described for intraoperative, multimodality electrophysiologic monitoring of the spinal cord and lumbosacral nerve roots (cauda equina). Simultaneous monitoring with the techniques of electromyography, compound muscle action potentials, and somatosensory evoked potentials is found to provide highly useful information to the surgeon during lumbar spine instrumentations. Compound muscle action potential recordings are used to identify nerve roots in the lumbosacral region, especially when visual identification of the nerve is hindered by scarring or distortion of the anatomy. Electromyography continuously monitors nerve roots at risk by revealing neurotonic discharges when the nerve roots are irritated during surgical dissection or placement of the fixation device. The early warning provided by this technique enables the surgeon to avoid irreversible neurologic damage.