Quantitative analysis of sensory functions after lumbar discectomy using current perception threshold testing

Abstract

A Neurometer device is an electrical nerve stimulator used to determine the current perception threshold (CPT) evoked by stimulating A-beta fibers at 2,000 Hz, A-delta fibers at 250 Hz and C fibers at 5 Hz. CPT evaluation is used for analyzing peripheral nerve dysfunction. In this study, the sensory disturbance of the lower-extremity was quantitatively analyzed using CPT testing before and after lumbar discectomy. In 33 patients (L4/5: 16 and L5/S: 17), as subjective evaluations, tactile sensation and leg pain were assessed before and 2 weeks after surgery. In the subjectively improved group (n = 22), significant decreases in CPT at 2,000 and 250 Hz were noted postoperatively, whereas in the unchanged group (n = 11), no significant changes in CPT at any frequencies was noted. The leg pain improved in all patients. Likewise, CPT at 5 Hz, which stimulated C fiber, decreased significantly for both improved and unchanged groups. CPT measured by a Neurometer is very useful in assessing lower-extremity sensory functions before and after surgery for lumbar disc herniation.

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References

  1. 1.

    Chado HN (1995) The current perception threshold evaluation of sensory nerve function in pain management. Pain Digest 5:127–134

    Google Scholar 

  2. 2.

    Chu N-S (1996) Current perception threshold in toe-to-digit transplantation and digit-to-digit replantation. Muscle Nerve 19:183–186

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Katims JJ, Long DM, Ng LK (1986) Transcutaneous nerve stimulation: frequency and waveform specificity in humans. Appl Neurophysiol 49:86–91

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Katims JJ, Mitsuhata H, Miyazaki T (1998) Electrodiagnostic evaluation of sensory nerve function in the patient with pain: neuroselective current perception threshold (CPT) and pain tolerance threshold (PTT). Pain Clinic 19:535–549

    Google Scholar 

  5. 5.

    Katims JJ, Naviasky EH, Rendell MS, Ng LK, Bleecker ML (1987) Constant current sine wave transcutaneous nerve stimulation for the evaluation of peripheral neuropathy. Arch Phys Med Rehabil 68:210–213

    PubMed  CAS  Google Scholar 

  6. 6.

    Katims JJ, Rouvelas P, Sadler BT, Weseley SA (1989) Reproducibility and comparison with nerve conduction in evaluation of carpal tunnel syndrome. Trans Am Soc Artif Intern Organs 35:280–283

    CAS  Google Scholar 

  7. 7.

    Katims JJ, Patil AS, Rendell MS et al. (1991) Current perception threshold screening for carpal tunnel syndrome. Arch Environ Health 46:207–212

    PubMed  CAS  Article  Google Scholar 

  8. 8.

    Masson EA, Boulton AJM (1991) The Neurometer: validation and comparison with conventional tests for diabetic neuropathy. Diab Med 8:563–566

    Article  Google Scholar 

  9. 9.

    Masson EA, Veves A, Fernando D, Boulton AJM (1989) Current perception threshold: A new, quick, and reproducible method for assessment of peripheral neuropathy in diabetes mellitus. Diabetology 32:724–728

    Article  CAS  Google Scholar 

  10. 10.

    Pelmear PL, Kusiak R (1994) Clinical assessment of hand-arm vibration syndrome. Nagoya J Med Sci 57(Suppl):27–41

    PubMed  Google Scholar 

  11. 11.

    Pitei DL, Watkins PJ, Stevens MJ, Edmonds ME (1994) The value of the Neurometer CPT in assessing diabetic neuropathy by measurement of the current perception threshold. Diab Med 11:872–876

    CAS  Google Scholar 

  12. 12.

    Rendell MS, Dovgan DJ, Bergman TF, O’Donnel GP, Drobny EP, Katims JJ (1989) Mapping diabetic sensory neuropathy by current perception threshold testing. Diab Care 12:636–640

    Article  CAS  Google Scholar 

  13. 13.

    Yamashita T, Kanaya K, Sekine M, Takebayashi T, Kawaguchi S, Katahira G (2002) A quantitative analysis of sensory function in lumbar radiculopathy using current perception threshold testing. Spine 27:1567–1570

    PubMed  Article  Google Scholar 

Download references

Acknowledgment

This study was supported by the Yuasa Memorial Foundation (2003 Research Grant).

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Correspondence to Tsuneo Takebayashi.

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Imoto, K., Takebayashi, T., Kanaya, K. et al. Quantitative analysis of sensory functions after lumbar discectomy using current perception threshold testing. Eur Spine J 16, 971–975 (2007). https://doi.org/10.1007/s00586-006-0285-7

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Keywords

  • Current perception threshold
  • Radiculopathy
  • Lumbar discectomy