Intraoperative monitoring of the dorsal sacral roots: Minimizing the risk of iatrogenic micturition disorders

Vedran Deletis, David B. Vodusek, Rick Abbott, Fred J. Epstein, Herman Turndorf

Research output: Contribution to journalArticle

75 Scopus citations

Abstract

In 31 children (age, 2–17 years) and 1 adult, individual dorsal root action potentials (DRAPs) from the S1-S3 roots were recorded intraoperatively after electrical stimulation of the dorsal penile or clitoral nerves, in preparation for surgery within the cauda equina. In most patients, pudendal afferent activity was present in S2 and S3 bilaterally; in some, the afferent activity was confined to a single root bilaterally, and in one, to a single root on one side. Dorsal root action potentials of small amplitude were recorded from S1 in 15 patients, although in no patient was S1 the primary carrier of these afferents. No lesion of the roots or rootlets carrying significant afferent activity was created during the rhizotomy, and no dysfunction in micturition resulted. We propose that the neurophysiological identification of roots and rootlets carrying afferent activity from the penile or clitoral nerves allows for rhizotomy of the S2 roots with the least possible risk of postoperative micturition and sexual dysfunction.

Original languageEnglish (US)
Pages (from-to)72-75
Number of pages4
JournalNeurosurgery
Volume30
Issue number1
DOIs
StatePublished - Jan 1992
Externally publishedYes

Keywords

  • Bladder dysfunction
  • Cauda equina
  • Intraoperative monitoring
  • Pudendal nerve
  • Rhizotomy
  • Sexual dysfunction

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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