Nerve Root Conduction Studies During Lumbar Disc Surgery
| Autor: | Carl V. Granger, Stevenson Flanigan |
|---|---|
| Rok vydání: | 1968 |
| Předmět: |
Nerve root
Neural Conduction Sensation Action Potentials Thigh medicine Humans Tibial nerve Evoked Potentials Motor Neurons Electromyography business.industry Muscles Lumbosacral Region Peripheral Nervous System Diseases Cauda equina Anatomy Sciatic Nerve Electric Stimulation Tendon Antidromic Spinal Nerves medicine.anatomical_structure Reflex business Sensory nerve |
| Zdroj: | Journal of Neurosurgery. 28:439-444 |
| ISSN: | 0022-3085 |
| DOI: | 10.3171/jns.1968.28.5.0439 |
| Popis: | M ETHODS for assessment of motor and sensory nerve conduction in peripheral nerves have proved valuable in clinical practice. 1-4,6,s Malcomb 7 reported on the reflex times of tendon jerks measured preoperatively. In addition he measured the speed of nerve conduction following stimulation within the theca of the cauda equina at the t ime of operation for removal of a compressing lesion; the affected root and the opposite normal one were bo th stimulated, and the results compared; there was slowing of the speed of the nerve-impulse conduction past the compressed segment of the nerve root. The purpose of our study was to demonstrate the conduction deficit that exists across the segment of a nerve root as a result of compression by herniated disc material. This assessment was made at the t ime of operative decompression. Mos t patients showed sufficient motor weakness, sensory disturbance, or reflex alteration for localization of the involved root. Only a few had preoperative myelographic or electromyographic examinations. The clinical material included 30 studies in 28 different patients, with 32 nerve root tests, four at L-4, 11 at L-5, and 17 at S-1. Three additional cases could not be categorized; in two of these, previous lumbar disc operations had caused scarring about the nerve roots which obscured the test results. of the cathode ray oscilloscope was used. A Polaroid Lane camera was mounted for a permanent record either f rom the direct sweep or f rom a Tektronix storage oscilloscope that was connected to the recording circuit. After dissection of the disc space and removal of herniated disc material, paired electroencephalographic needle electrodes were inserted through the dural sleeve of the nerve root at locations above and below the site of compression (Fig. 1). These electrodes were used both for stimulating motor impulses to the muscles and for recording afferent combined antidromic moto r and or thodromic sensory impulses following stimulation of the peroneal or tibial nerve in the popliteal space. A broad ground electrode was placed under the opposite thigh. In a few instances the studies were per formed upon exposure of the nerve root, pr ior to manipulat ion or traction. Repeat studies following removal of disc material showed no change in recorded responses. |
| Databáze: | OpenAIRE |
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