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Functional myotome mapping via triggered electromyography during intraoperative cervical rootlet stimulation
Hangeul Park1, Woojin Kim1, Jungbo Sim1
1Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
Medicine
|February 27, 2026
Summary
This study developed a new cervical myotome map using triggered electromyography (tEMG) during surgery. Findings reveal discrepancies with traditional charts, suggesting a refined understanding of cervical nerve function for improved surgical accuracy.
Area of Science:
- Neurosurgery
- Neurophysiology
- Spinal Anatomy
Background:
- Current cervical myotome charts lack electrophysiological validation and exhibit inconsistencies.
- Accurate myotome mapping is crucial for neurosurgical practice and understanding cervical nerve function.
Purpose of the Study:
- To create a functional cervical myotome map using amplitude-based triggered electromyography (tEMG).
- To validate cervical myotome innervation through intraoperative direct rootlet stimulation.
Main Methods:
- Retrospective analysis of 20 patients undergoing cervical spinal tumor resection with intraoperative rootlet stimulation.
- Direct stimulation of ventral cervical rootlets and recording of tEMG responses in specific muscles.
- Quantitative mapping based on maximum tEMG amplitude for each rootlet level.
Main Results:
- Stimulation of 33 cervical rootlets revealed functional mapping discrepancies compared to traditional charts.
- C4 rootlet showed significant abductor pollicis brevis (APB) activation, and C6 innervated multiple muscles including APB.
- C8 and T1 rootlets produced highest amplitudes in APB, with some atypical activations observed.
Conclusions:
- Amplitude-based tEMG mapping offers a quantitative method for refining cervical myotome charts.
- Findings suggest potential re-evaluation of traditional cervical myotome distributions.
- This technique may enhance diagnostic and surgical accuracy in managing cervical spine disorders, though tumor effects warrant consideration.
