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Related Experiment Videos

Spinal nerve stimulation in S1 radiculopathy.

W S Pease1, F P Lagattuta, E W Johnson

  • 1Ohio State University College of Medicine, Dept. of Physical Medicine, Columbus 43210.

American Journal of Physical Medicine & Rehabilitation
|April 1, 1990
PubMed
Summary

Direct S1 spinal nerve stimulation helps pinpoint H reflex pathway issues. This electrodiagnostic technique differentiates peripheral versus spinal conduction slowing in S1 radiculopathy, improving diagnostic accuracy.

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Area of Science:

  • Neuroscience
  • Clinical Electrophysiology
  • Neurology

Background:

  • The H reflex is a key electrodiagnostic tool but lacks segmental specificity.
  • Its long conduction pathway limits precise localization of nerve injury.
  • Differentiating peripheral versus central conduction abnormalities is clinically important.

Purpose of the Study:

  • To evaluate direct S1 spinal nerve stimulation for segment-specific H reflex pathway assessment.
  • To differentiate peripheral and spinal conduction slowing in S1 radiculopathy.
  • To enhance diagnostic accuracy in lumbosacral injuries.

Main Methods:

  • Conducted standard H reflex studies in patients with S1 radiculopathy (n=77) and controls (n=56).
  • Performed monopolar needle stimulation of the first sacral spinal nerve.

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  • Calculated the S1 ratio (spinal nerve latency / H reflex latency).

    • Main Results:

    • An abnormal S1 ratio was observed in 77% of S1 radiculopathy patients, indicating spinal segment slowing.
    • The remaining patients showed slowed conduction in both spinal and peripheral segments, suggesting Wallerian degeneration.
    • The S1 ratio effectively identified slowing within the intraspinal nerve segments.

    Conclusions:

    • Direct S1 spinal nerve stimulation provides valuable segmental information for H reflex pathway evaluation.
    • The S1 ratio aids in distinguishing between intraspinal and peripheral nerve injuries.
    • This technique is particularly useful for acute lumbosacral injuries where standard EMG may be inconclusive.