Pre- and Intraoperative Electrodiagnosis of Compressive Lumbosacral Nerve Root Lesions
Thirty-four patients with radiologically undetectable compressive lumbosacral radiculopathy, who had been surgically treated, were evaluated preoperatively according to electromyography (EMG), somatosensory evoked potential obtained by single root stimulation (root SEP), and elicited pain produced by root stimulation. Comparing the diagnostic accuracy of each preoperative test, the elicited pain test showed the highest accuracy rate (87.5%) and root SEP revealed abnormality with a rate of 80.8%. On the other hand, EMG detected nerve root lesions at a rate of 71.7%. However, a combination of different electrodiagnostic tests is necessary to improve the detection rate of lumbar radiculopathy. In addition, intraoperative electrodiagnosis was also conducted in 15 cases. Action potentials of the cauda equina (CEAP) and the nerve root (ERP) recorded directly from the operative site provided more precise information about the site of nerve root lesions.
KeywordsNerve Root Disc Herniation Japanese Orthopedic Association Score Positive Wave Lumbar Spinal Canal Stenosis
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