Related Experiment Video
Updated: Apr 20, 2026
Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
Published on: June 26, 2018
Distal spinal cord stimulation in infants with myelomeningoceles: preliminary study
1Pediatric Neurosurgery, Department of Surgery, Kijabe Hospital, Kijabe, Kenya; and Department of Neurosurgery, University of Wisconsin Health Center, Madison, Wisconsin.
Insights
Stimulating the spinal cord in infants with myelomeningocele only caused lower extremity muscle contraction if nerves exited the cord before the neural placode. This suggests current spread may cause contractions, not direct stimulation.
Area of Science:
- Neuroscience
- Pediatric Surgery
- Developmental Biology
Background:
- Myelomeningocele is a complex birth defect affecting spinal cord development.
- Understanding nerve pathways is crucial for managing lower extremity function in affected infants.
Purpose of the Study:
- To investigate the impact of stimulating the distal spinal cord, near the neural placode, on lower extremity muscle function in infants with myelomeningocele.
- To determine if direct stimulation or current spread causes muscle response.
Main Methods:
- Electrical stimulation of the lateral spinal cord using a monopolar probe in 13 infants with lumbosacral myelomeningocele.
- Monitoring lower extremity muscle responses with a neural integrity monitor.
- Assessing functional changes after distal cordectomies.
Main Results:
- No lower extremity muscle contraction occurred in 7 infants without exiting nerves between the spinal canal and neural placode.
- Muscle contraction was observed in infants with exiting nerves in this region.
- Distal cordectomies did not result in loss of movement.
Conclusions:
- Direct monopolar stimulation of the lateral spinal cord does not reliably induce lower extremity muscle contraction.
- Muscle response appears dependent on the presence of nerve roots exiting the cord between the spinal canal and neural placode.
- Observed contractions may be attributed to current spread from the monopolar stimulator rather than direct nerve activation.
Object:
The purpose of this study of infants with myelomeningoceles was to evaluate the effect of stimulation of the distal spinal cord, proximal to the neural placode, on functioning lower-extremity muscles distal to the placode.
Methods:
In 13 infants with lumbosacral myelomeningoceles, the lateral spinal cord was stimulated, with a monopolar probe, between its exit from the spinal canal and the neural placode. Responses of functional muscles in the lower extremities were monitored with a neural integrity monitor.
Results:
Stimulation of the lateral spinal cord resulted in no contraction of lower-extremity muscles in 7 of 13 infants in whom no nerves exited the cord between the spinal canal and the neural placode. In those with exiting nerves in that location, stimulation of the cord resulted in the contraction of functional muscles. Distal cordectomies at the junction between the spinal cord and the neural placode, distal to any nerve roots exiting from the cord, resulted in no loss of movement.
Conclusions:
Monopolar stimulation of the lateral spinal cord does not seem to cause contraction of functional lower-extremity muscles unless nerve roots to the lower extremities exit the cord distal to the spinal canal but before its junction with the neural placode. Muscle contraction in cases in which nerve roots exit the spinal cord between the canal and the placode may be caused by the spread of current from the monopolar stimulator.
