Electrical stimulation and multichannel EMG recording for identification of functional neural tissue during cauda equina surgery

Alan D. Legatt, Charles E. Schroeder, Bhagwant Gill, James T. Goodrich

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

Electrical stimulation of structures within the surgical field was used to identify functional neural elements during 25 cauda equina operations. EMG responses from anterior thigh, posterior thigh, and anal sphincter muscles were recorded simultaneously using a multichannel signal averager. During nine operations, stimulation of a presumed filum terminale or other tissue produced clear EMG responses, prompting modification of surgical procedures. In one patient, this resulted in preservation of a flattened spinal cord which resembled a band of scar tissue. Some EMG responses were restricted to a single muscle group; these neural structures would probably not have been identified if only a single-channel EMG recording was used. Visual examination alone was not adequate for identifying functional neural elements, or for determining whether atretic-appearing nerve roots were functional. Electrical stimulation with multichannel EMG recording facilitates the preservation of functional neural elements and the optimization of surgical results in cauda equina surgery.

Original languageEnglish (US)
Pages (from-to)185-189
Number of pages5
JournalChild's Nervous System
Volume8
Issue number4
DOIs
StatePublished - Jun 1 1992

Keywords

  • Cauda equina surgery
  • Electric stimulation
  • Electromyography
  • Evoked potentials, somatosensory
  • Intraoperative neurophysiologic monitoring
  • Tethered spinal cord

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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