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Monitoring of nerve root injury using transcranial motor-evoked potentials in a pig model.
Spine (Phila Pa 1976). 2008 Jun 15; 33(14):E465-73.S

Abstract

STUDY DESIGN

Animal experiment using transcranial motor-evoked potentials (tcMEPs) in a pig model.

OBJECTIVE

To validate measurement of tcMEPs from multiple myotomes in a pig model and determine the capacity to detect injury to a single nerve root.

SUMMARY OF BACKGROUND DATA

The ability of intraoperative neuromonitoring methods to give information about a single nerve root remains poorly understood. Reports suggest that tcMEPs may be a reliable and accurate method to detect nerve root injury. An animal model to study the sensitivity and specificity of this technique has yet to be validated.

METHODS

Transcranial stimulation was delivered through customized electrodes placed in burr holes over the motor cortex in 7 pigs. Spontaneous and evoked muscle potential activity was recorded in 5 myotomes (rectus femoris, vastus lateralis, vastus medialis, tibialis anterior, and gastrocnemius) bilaterally. After unilateral exposure of the L3-S1 nerve roots, sequential ligations were performed. The tcMEP responses from all myotomes were measured after ligation of each nerve root.

RESULTS

Robust MEP responses (range, 37-1165 mV) were achieved in all monitored myotomes. Significant decreases in tcMEP amplitudes occurred in specific myotomes after ligation of the corresponding nerve root. Consistent and substantial decreases were observed after L3 and L5 ligations in rectus femoris (48%) and tibialis anterior (67%), respectively.

DISCUSSION

Our results validate monitoring of tcMEPs in multiple myotomes to detect nerve root injury in pigs. This model may be used for further study of the use of tcMEPs to detect predictors and risk factors of nerve root injury during spinal surgery.

Authors+Show Affiliations

Department of Orthopaedic Surgery, University of California, San Francisco, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18552661

Citation

Mok, James M., et al. "Monitoring of Nerve Root Injury Using Transcranial Motor-evoked Potentials in a Pig Model." Spine, vol. 33, no. 14, 2008, pp. E465-73.
Mok JM, Lyon R, Lieberman JA, et al. Monitoring of nerve root injury using transcranial motor-evoked potentials in a pig model. Spine. 2008;33(14):E465-73.
Mok, J. M., Lyon, R., Lieberman, J. A., Cloyd, J. M., & Burch, S. (2008). Monitoring of nerve root injury using transcranial motor-evoked potentials in a pig model. Spine, 33(14), E465-73. https://doi.org/10.1097/BRS.0b013e318178e67f
Mok JM, et al. Monitoring of Nerve Root Injury Using Transcranial Motor-evoked Potentials in a Pig Model. Spine. 2008 Jun 15;33(14):E465-73. PubMed PMID: 18552661.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Monitoring of nerve root injury using transcranial motor-evoked potentials in a pig model. AU - Mok,James M, AU - Lyon,Russ, AU - Lieberman,Jeremy A, AU - Cloyd,Jordan M, AU - Burch,Shane, PY - 2008/6/17/pubmed PY - 2008/9/4/medline PY - 2008/6/17/entrez SP - E465 EP - 73 JF - Spine JO - Spine VL - 33 IS - 14 N2 - STUDY DESIGN: Animal experiment using transcranial motor-evoked potentials (tcMEPs) in a pig model. OBJECTIVE: To validate measurement of tcMEPs from multiple myotomes in a pig model and determine the capacity to detect injury to a single nerve root. SUMMARY OF BACKGROUND DATA: The ability of intraoperative neuromonitoring methods to give information about a single nerve root remains poorly understood. Reports suggest that tcMEPs may be a reliable and accurate method to detect nerve root injury. An animal model to study the sensitivity and specificity of this technique has yet to be validated. METHODS: Transcranial stimulation was delivered through customized electrodes placed in burr holes over the motor cortex in 7 pigs. Spontaneous and evoked muscle potential activity was recorded in 5 myotomes (rectus femoris, vastus lateralis, vastus medialis, tibialis anterior, and gastrocnemius) bilaterally. After unilateral exposure of the L3-S1 nerve roots, sequential ligations were performed. The tcMEP responses from all myotomes were measured after ligation of each nerve root. RESULTS: Robust MEP responses (range, 37-1165 mV) were achieved in all monitored myotomes. Significant decreases in tcMEP amplitudes occurred in specific myotomes after ligation of the corresponding nerve root. Consistent and substantial decreases were observed after L3 and L5 ligations in rectus femoris (48%) and tibialis anterior (67%), respectively. DISCUSSION: Our results validate monitoring of tcMEPs in multiple myotomes to detect nerve root injury in pigs. This model may be used for further study of the use of tcMEPs to detect predictors and risk factors of nerve root injury during spinal surgery. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/18552661/Monitoring_of_nerve_root_injury_using_transcranial_motor_evoked_potentials_in_a_pig_model_ L2 - http://dx.doi.org/10.1097/BRS.0b013e318178e67f DB - PRIME DP - Unbound Medicine ER -