Intraoperative motor and sensory monitoring of the cauda equina.

Abstract:

:A set of standard techniques to monitor the motor and sensory function of the cauda equina is proposed for surgery in the lumbosacral spinal canal for the release of a tethered cord or the removal of a neoplasm. Continuous loudspeaker-controlled recording of electromyographic activity in four leg muscles of both sides supplied the surgeon with immediate feedback on injury to any of the motor roots from the second lumbar to the fourth sacral segment. Continuous recording of tibial nerve somatosensory evoked potentials yielded information about the functional state of parts of the lumbosacral sensory pathways. Motor roots could be identified by electrical stimulation in the operating field with bipolar stimulation forceps and recording of compound muscle action potentials from the leg muscles. Sensory nerve roots could be identified by nerve root somatosensory evoked potentials recorded from the scalp after the electrical stimulation of the exposed nerve. This set-up is a combination of previously developed monitoring techniques and provides the surgeon with functional information: 1) continuous feedback on the state of the endangered motor and sensory function of the cauda equina; and 2) rapid anatomical identification of nerve roots and their distinction from fibrous or neoplastic structures.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Kothbauer K,Schmid UD,Seiler RW,Eisner W

doi

10.1227/00006123-199404000-00020

subject

Has Abstract

pub_date

1994-04-01 00:00:00

pages

702-7; discussion 707

issue

4

eissn

0148-396X

issn

1524-4040

journal_volume

34

pub_type

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