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Coexisting peripheral nerve and cervical cord compression

K Kaneko1, S Kawai, T Taguchi

  • 1Department of Orthopedic Surgery, University of Yamaguchi, School of Medicine, Japan.

Spine
|March 15, 1997
PubMed
Summary
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Measuring central motor conduction time via motor evoked potentials is a valuable screening tool for diagnosing combined peripheral nerve and cervical cord lesions, aiding in effective treatment planning.

Area of Science:

  • Neuroscience
  • Clinical Electrophysiology
  • Neurology

Background:

  • Transcranial magnetic stimulation (TMS) is established for diagnosing cervical myelopathy.
  • TMS may also aid in assessing patients with concurrent entrapment neuropathy and cervical myelopathy.

Purpose of the Study:

  • To evaluate the clinical utility of motor evoked potentials (MEPs) in patients with simultaneous peripheral nerve and cervical cord lesions.
  • To establish central motor conduction time (CMCT) measurement as a screening method for these double lesions.

Main Methods:

  • Recorded MEPs, compound muscle action potentials, and F waves from abductor policis brevis and abductor digiti minimi.
  • Calculated CMCT by subtracting peripheral conduction time from MEP latency.

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Main Results:

  • Seven of ten patients with double lesions showed prolonged CMCT (avg. 2.5 SD above normal).
  • Two patients with ossification of the posterior longitudinal ligament had normal CMCT despite MRI-confirmed spinal cord compression.
  • Symptomatic improvement occurred in two patients after surgery on entrapment lesions alone.

Conclusions:

  • CMCT measurement using MEPs is an effective diagnostic method for patients presenting with both entrapment neuropathy and cervical cord compression.
  • This technique aids in identifying and managing complex neurological conditions.