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Quantitative analysis of sensory functions after lumbar discectomy using current perception threshold testing.

Kenshi Imoto1, Tsuneo Takebayashi, Kunihito Kanaya

  • 1Department of Orthopaedic Surgery, School of Medicine, Sapporo Medical University, Sapporo 060-8543, Japan.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|January 5, 2007
PubMed
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Neurometer device testing of current perception threshold (CPT) effectively assesses lower-extremity nerve function after lumbar discectomy. CPT changes correlate with sensory improvements, aiding surgical outcome evaluation.

Area of Science:

  • Neurology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Peripheral nerve dysfunction can cause sensory disturbances in the lower extremities.
  • Current perception threshold (CPT) testing quantifies nerve fiber function.
  • Lumbar discectomy is a common surgical procedure for herniated discs.

Purpose of the Study:

  • To quantitatively analyze lower-extremity sensory disturbance using CPT testing before and after lumbar discectomy.
  • To evaluate the correlation between CPT changes and subjective improvements in sensation and pain.
  • To determine the utility of the Neurometer device in assessing surgical outcomes.

Main Methods:

  • A Neurometer device was used to measure CPT at frequencies stimulating A-beta (2,000 Hz), A-delta (250 Hz), and C fibers (5 Hz).

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  • CPT was assessed in 33 patients pre- and post-lumbar discectomy (2 weeks).
  • Subjective evaluations included tactile sensation and leg pain assessments.
  • Main Results:

    • In the subjectively improved group (n=22), significant CPT decreases were observed at 2,000 Hz and 250 Hz postoperatively.
    • No significant CPT changes were noted in the unchanged group (n=11).
    • Leg pain improved in all patients, and CPT at 5 Hz (C fiber) significantly decreased in both improved and unchanged groups.

    Conclusions:

    • CPT measurement using a Neurometer is valuable for assessing lower-extremity sensory function.
    • CPT changes correlate with subjective improvements following lumbar discectomy.
    • The Neurometer provides objective data for evaluating the efficacy of lumbar discectomy on nerve function.