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Mechanically elicited nerve root discharge: mechanical irritation and waveform
1Department of Neurology, National Shizuoka Hospital, Japan.
Acta Neurologica Scandinavica
|September 9, 1999
Summary
Monitoring lumbar nerve roots during surgery using mechanically elicited EMG can identify irritation. Different waveforms indicate the type and strength of mechanical stimulation, helping prevent nerve damage.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neuromonitoring
Background:
- Intraoperative monitoring is crucial for safeguarding nerve roots during lumbar surgery for spinal degeneration.
- Understanding the relationship between mechanical stimuli and nerve root responses is essential for surgical safety.
Purpose of the Study:
- To evaluate the correlation between mechanical irritation types and waveform characteristics of mechanically elicited electromyography (EMG) during lumbar surgery.
- To determine the utility of monitoring mechanically elicited EMGs for preventing nerve root deficits.
Main Methods:
- Mechanically elicited EMGs were recorded bilaterally from muscle groups innervated by lumbar nerve roots.
- Recordings were performed in 24 consecutive patients undergoing surgery for lumbar spinal degenerative disease.
Main Results:
- Surgical irritation generated three distinct nerve root discharge waveforms: short, waning, and continuous.
- These waveforms were readily elicited mechanically and showed sensitivity to the type and intensity of stimulation.
- The observed waveforms correlated with the mechanical manipulation applied to the nerve roots.
Conclusions:
- Mechanical irritation of lumbar nerve roots can elicit specific EMG discharges without causing post-operative deficits.
- Monitoring mechanically elicited EMGs during spinal degeneration surgery is a potentially valuable tool for nerve root protection.