Intraoperative Use of Dermatomal Somatosensory-evoked Potentials in Lumbar Stenosis Surgery

Herron, Larry D.; Trippi, Anthony C.; Gonyeau, Marylou

doi:10.1097/00007632-198705000-00014

Cited by 33 publications

(6 citation statements)

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“…A new approach can be seen in the use of dermatomal SEP, latencies of which appeared to be reliable indicators of adequate lumbar nerve root decompression intraoperatively. 34 Cervical dermatomal SEP and SCEP after finger stimulation35 may become a helpful device for intra operative electrodiagnosis or monitoring of decompression procedures in cervical spinal surgery. As for spinal recordings, two methods are to be distinguished.…”

Section: Different Techniquesmentioning

confidence: 99%

Recent developments in neurosurgical spinal cord monitoring

Schramm

Kurthen

1992

Spinal Cord

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Section: Different Techniquesmentioning

confidence: 99%

Recent developments in neurosurgical spinal cord monitoring

Schramm

Kurthen

1992

Spinal Cord

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“…DSEPs test specific dermatomes with standardized normal values. As previously mentioned, DSEPs can provide useful information when monitoring of a single root is needed (56). A study by Snowden et al (62) showed DSEPs to be a helpful adjunct to CT and MRI imaging when diagnosing LSS.…”

Section: N Ne Ee Ed DL Le E E Em Mg Gmentioning

confidence: 97%

“…SEPs more suited for low-grade, chronic compression seen in LSS (54) rather than for acute radiculopathies. SEPs provide a good overall picture of the status of multi-level nerve function (56). Typically, SEPs are normal in the early stages of LSS when symptoms first begin.…”

Section: N Ne Ee Ed DL Le E E Em Mg Gmentioning

confidence: 99%

Electrodiagnosis in Lumbar Spinal Stenosis: A Review

Kishner¹,

Gündüz²,

Gupta³

et al. 2010

tftr

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S Su um mm ma ar ry yLumbar spinal stenosis (LSS) is a narrowing of the spinal canal and/or the neuroforamina through which the spinal cord roots enter and exit. The symptoms of LSS usually begin over the course of several months and include neurogenic claudication. This is characterized by low back pain that radiates down one or both legs producing pain or weakness. LSS can be quite debilitating and can have a profound negative effect on one's activities of daily living and overall quality of life. Imaging studies, such as computed tomography (CT) and magnetic resonance imaging (MRI) are routinely performed in the work-up of suspected LSS. In recent years, there has been much controversy over the actual clinical usefulness of these studies. When compared to electrodiagnostic studies, CT and MRI have been shown to have increased false negative and false positive rates. Electrodiagnostic studies show dynamic physiological neural function and has become a valuable tool in LSS. This information can be used to determine the location and severity of LSS, differentiate LSS from other conditions, and monitor the progression. Electrodiagnostic techniques such as somatosensory evoked potentials, dermatomal somatosensory evoked potentials (DSEPs), and paraspinal mapping (PM) increase both the sensitivity and specificity in diagnosing LSS. DSEPs provide useful information on multi-level, multiple rootlet disease. PM reflects the physiology of nerve roots and has been found to be superior to extremity needle EMG. Electrodiagnostic techniques are becoming the standard in the diagnosis and therapeutic decisions for LSS and other related diseases.Turk J Phys Med Rehab 2010;56:75-80. K Ke ey y W Wo or rd ds s: : Lumbar spinal stenosis, electrodiagnosis, low back pain, lumbar radiculopathy, paraspinal mapping Ö Öz ze et t Spinal kanalda ya da sinir köklerinin geçti¤i nöral foramenlerde daralma lomber spinal stenoz (LSS) olarak adland›r›l›r. LSS yaflam kalitesini belirgin derecede etkileyip engellili¤e neden olabilir. LSS'nin belirtileri aylar içinde ortaya ç›kar. Nörojenik klodikasyon, tek ya da her iki alt ekstremiteye yay›lan bel a¤r›s› ve güçsüzlük LSS'nin semptomlar› aras›nda say›labilir. LSS düflünülen olgularda bilgisayarl› tomografi (BT) ve manyetik rezonans görüntüleme (MRG) gibi yöntemler rutin olarak kullan›lmaktad›r. Fakat bu tetkiklerin LSS tan›s›na katk›s› ile ilgili tart›flma-lar giderek artmaktad›r. Elektrodiagnostik çal›flmalarla karfl›laflt›r›ld›-¤›nda BT ve MRG'nin yalanc› negatif ve yalanc› pozitiflikleri daha fazlad›r. Nöral fonksiyonlar›n gerçek zamanl› durumunu ortaya koyan elektrodiagnostik incelemeler LSS'de oldukça yararl›d›r. Elektrodiagnoz ayr›ca, LSS'nin lokalizasyonu ve fliddeti konusunda bilgi verir; hastal›¤›n ay›r›c› tan›s›nda ve progresyonunun takibinde de yararl›d›r. Somatosensoriyel uyand›r›lm›fl potansiyeller, dermatomal somatosensoriyel uyand›r›lm›fl potansiyeller (DSEP) ve paraspinal haritalama (PH) gibi elektrodiagnostik teknikler LSS tan›s›nda duyarl›l›k ve özgüllü¤ü artt›rmak-tad›r. DSEP,...

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“…There are few techniques for intraoperative neuromonitoring of a single nerve root, and no reliable method has been established. [5][6][7][8][9][10][11][12][13][14]18,19 Spontaneous or evoked electromyographic (EMG) activity recorded from appropriate muscle groups has proven useful, providing information about specific nerve root injuries in the lumbosacral spine. 5,6,10 Dermatomal spinal somatosensory-evoked potentials (D-SSEP) obtained from the stimulation of different dermatomes have been advocated as a useful alternative route because such potentials seem to reflect the specific conduction of the supplying nerve root.…”

mentioning

confidence: 99%