Dermatomal/segmental somatosensory evoked potential evaluation of L5/S1 unilateral/unilevel radiculopathies

Dumitru, Daniel; Dreyfuss, Paul

doi:10.1002/(sici)1097-4598(199604)19:4<442::aid-mus3>3.0.co;2-c

Cited by 51 publications

(21 citation statements)

References 38 publications

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“…Positive L4, L5, or S1 SEP therefore strongly indicate corresponding true nerve root compromise. The results also indicate that the true-positive rate is higher in patients with facet joint hypertrophy than in patients with disc pathology alone, in agreement with the view that SEP may be useful in patients with spinal stenosis [33,49,52], but less useful in patients with disc pathology without elements of bony entrapment [1,5,14,53]. Some of the variations between the results obtained in previous studies may be related to different prevalences of bony entrapment in the patients included in the study, since some of the studies reporting usefulness of SEP in patients with low back pain and sciatic radicular symptoms did not exclude patients with stenosis of the spinal canal or lateral recesses [30,31,46].…”

Section: Discussionsupporting

confidence: 83%

Diagnostic validity of somatosensory evoked potentials in subgroups of patients with sciatica

Pape¹,

Eldevik

Vandvik³

2001

Eur Spine J

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Section: Discussionsupporting

confidence: 83%

Diagnostic validity of somatosensory evoked potentials in subgroups of patients with sciatica

Pape¹,

Eldevik

Vandvik³

2001

Eur Spine J

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“…On the other hand, Dumitru and Drefyuss questioned the accuracy of DSEP. They related the limitation of their study to several factors including, the small sample size (20 patients), the high degree of biologic variation of the reference values, the degree of nerve root compromise and the type of nerve fibers pathology that influence SEP yield [17]. Others also doubted the diagnostic utility of DSEP and suggested the need of further investigation [10].…”

Section: Discussionmentioning

confidence: 99%

Correlation between Dermatomal Somatosensory Evoked Potential, Needle Electromyography and Magnetic Resonance Imaging in Chronic Sensory Lumbosacral Radiculopathies

Hussein¹,

Abdelraouff²

2016

Int J Phys Med Rehabil

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Objective: To correlate between dermatomal somatosensory evoked potential (DSEP), needle electro myography (EMG) and magnetic resonance imaging (MRI) in patients with clinical picture suggestive of chronic sensory lumbosacral radiculopathy.Design: cross sectional study. Setting: outpatient setting.Participants: 50 patients (29 Males, 21 Females) with chronic sensory lumbosacral radiculopathy. 20 healthy subjects were included as control for DSEP values. Main outcome measures:Medical history, detailed neurological examination, Lumbosacral MRI, lumbosacral DSEP and needle EMG for segment pointing muscles were done for all patients. DSEP were done for lumbosacral roots for control subjects. Results:Mean age of patients 56.36 ± 10.26. Mean disease duration 17.48 ± 6.85 months.Spondylosis constituted 74%, followed by spinal stenosis 14%, lumbar disc prolapse 8%, lastly spondylolithesis 4% In relation to sensory symptoms, DSEP is significantly higher than EMG in detecting lumbosacral radiculopathies (p=0.0001). DSEP sensitivity and accuracy is higher than needle EMG at L4, L5 and S1 In relation to MRI, sensitivity of DSEP at L4 was 93.3%, at L5 and S1 100%. Sensitivity of needle EMG at L4 was 20%, at L5 24.3%, at S1 47.1% . Conclusion: DSEP is highly sensitive than needle EMG in diagnosing and localizing chronic sensory lumbosacral radiculpathies, even if MRI findings are inconclusive.

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“…Therefore, the final opinion seems to be that dSEPs do not have sufficient sensitivity in detecting single radicular lesions. 5,22 The possible explanation for this conclusion is that dSEPs are carried out by stimulating signature areas corresponding to dermatomal/segmental levels, assuming that a single dermatomal segment is excited at each stimulation point and the response is sufficiently selective to reflect the function of a particular sensory root. On the contrary, there is usually some overlap between adjacent dermatomes and the area on the skin chosen for stimulation is rarely innervated by a single nerve root.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic use of dermatomal somatosensory-evoked potentials in spinal disorders: Case series

Dikmen

Öge

2013

The Journal of Spinal Cord Medicine

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Objective/Context: Dermatomal somatosensory-evoked potentials (dSEPs) may be valuable for diagnostic purposes in selected cases with spinal disorders. Design: Reports on cases with successful use of dSEPs. Findings: Cases 1 and 2 had lesions causing multiple root involvement (upper to middle lumbar region in Case 1 and lower sacral region in Case 2). Cystic lesions in both cases seemed to compress more than one nerve root, and stimulation at the center of the involved dermatomes in dSEPs helped to reveal the functional abnormality. Cases 3 and 4 had lesions involving the spinal cord with or without nerve root impairment. In Case 3, an magnetic resonance imaging (MRI)-verified lesion seemed to occupy a considerable volume of the lower spinal cord, causing only very restricted clinical sensory and motor signs. In Case 4, a cervical MRI showed a small well-circumscribed intramedullary lesion at right C2 level. All neurophysiological investigations were normal in the latter two patients (motor, tibial, and median somatosensory-evoked potentials in Case 3, and electromyography in both) except for the dSEPs. Conclusions: Objectifying the presence and degree of sensory involvement in spinal disorders may be helpful for establishing diagnoses and in therapeutic decision-making. Valuable information could be provided by dSEPs in selected patients with multiple root or spinal cord involvement.

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Dermatomal/segmental somatosensory evoked potential evaluation of L5/S1 unilateral/unilevel radiculopathies

Cited by 51 publications

References 38 publications

Diagnostic validity of somatosensory evoked potentials in subgroups of patients with sciatica

Diagnostic validity of somatosensory evoked potentials in subgroups of patients with sciatica

Correlation between Dermatomal Somatosensory Evoked Potential, Needle Electromyography and Magnetic Resonance Imaging in Chronic Sensory Lumbosacral Radiculopathies

Diagnostic use of dermatomal somatosensory-evoked potentials in spinal disorders: Case series

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