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Efficacy of intraoperative direct electrical stimulation of the spinal root and measurement of distal motor latency in lumbar spinal stenosis

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Abstract

Purpose

The measurement of distal motor latency (DML) is an established method for diagnosing entrapment peripheral neuropathy. DML can also serve as an index for disease severity and prognosis. We considered that measuring DML could be useful in estimating the severity of spinal root impairment and predicting prognosis in patients with lumbar spinal stenosis (LSS). The purpose of this study was to investigate the efficacy of intraoperative direct electrical stimulation of the spinal root and the measurement of DML in LSS.

Methods

In 39 patients with LSS, a total of 93 spinal roots were stimulated, and evoked electromyography was recorded at the leg muscles after decompression. DML was measured and its correlation with clinical severity, as evaluated by Zurich claudication questionnaire (ZCQ) and Short Form 36 (SF-36), was investigated.

Results

For the stimulation of the L3, L4, and L5 spinal root, the mean DML (ms) were 6.8 (±1.4), 7.4 (±1.3), and 6.0 (±1.3) in gluteus medius, 9.3 (±1.5), 9.2 (±1.5), and 9.0 (±1.6) in biceps femoris, 9.7 (±1.0), 9.8 (±1.8), and 9.4 (±1.2) in vastus medialis, 16.1 (±1.0), 14.7 (±1.3), and 14.1 (±1.5) in tibialis anterior, and 16.4 (±1.4), 14.3 (±1.8), and 13.9 (±1.9) in gastrocnemius muscles. Statistically significant positive correlations were observed between DML and height. Preoperative symptom and function scores of ZCQ and postoperative bodily pain scores of SF-36 were significantly worse in the patients with prolonged DML.

Conclusions

DML is thought to be useful for estimating the severity of spinal root impairment and for predicting the prognosis.

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Authors and Affiliations

  1. Department of Clinical Engineering, Sapporo Medical University Hospital, S1 W16, Sapporo, Hokkaido, 060-8543, Japan

    Takao Murohashi, Shuichi Hashimoto & Shouto Yamada

  2. Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, S1 W16, Sapporo, Hokkaido, 060-8543, Japan

    Mitsunori Yoshimoto, Tsuneo Takebayashi & Toshihiko Yamashita

  3. Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, S1 W16, Sapporo, Hokkaido, 060-8543, Japan

    Hiroyuki Takashima

Authors
  1. Takao Murohashi
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  2. Mitsunori Yoshimoto
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  3. Tsuneo Takebayashi
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  4. Shuichi Hashimoto
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  5. Shouto Yamada
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  6. Hiroyuki Takashima
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  7. Toshihiko Yamashita
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Correspondence to Mitsunori Yoshimoto.

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No funds were received in support of this work. No benefits in any form have been or will be received from any commercial party related directly or indirectly to the subject of this manuscript.

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The authors declare that they have no conflict of interest.

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Murohashi, T., Yoshimoto, M., Takebayashi, T. et al. Efficacy of intraoperative direct electrical stimulation of the spinal root and measurement of distal motor latency in lumbar spinal stenosis. Eur Spine J 26, 434–440 (2017). https://doi.org/10.1007/s00586-016-4772-1

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  • DOI: https://doi.org/10.1007/s00586-016-4772-1

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