Repeated L5 Nerve Root Compromise Detected with Motor Evoked Potentials (MEP), but Not Electromyography (EMG): A Case Report

References

• Ajiboye RM, Zoller SD, D’Oro A, Burke ZD, Sheppard W, Wang C, Buser Z, Wang JC, Pourtaheri S. 2017. Utility of intraoperative neuromonitoring for lumbar pedicle screw placement is questionable. Spine. 42(13):1006–1010.
   PubMed Web of Science ®Google Scholar
• Charalampidis A, Jiang F, Wilson JRF, Badhiwala JH, Brodke DS, Fehlings MG. 2020. The use of intraoperative neurophysiological monitoring in spine surgery. Glob Spine. 10(suppl 1):104S–114S.
   PubMedGoogle Scholar
• Fan D, Schwartz DM, Vaccaro AR, Hilibrand AS, Albert TJ. 2002. Intraoperative neurophysiologic detection of iatrogenic C5 nerve root injury during laminectomy for cervical compression myelopathy. Spine. 27(22):2499–2502.
   PubMed Web of Science ®Google Scholar
• Georgoulis G, Sindou M. 2020. Muscle responses to radicular stimulation during lumbo-sacral dorsal rhizotomy for spastic diplegia: insights into myotomal innervation. Clin Neurophysiol. 131(5):1075–1086.
   PubMed Web of Science ®Google Scholar
• Lieberman JA, Lyon R, Jasiukaitis P, Berven SH, Burch S, Feiner J. 2019. The reliability of motor evoked potentials to predict dorsiflexion injuries during lumbosacral deformity surgery: importance of multiple myotomal monitoring. Spine J. 19(3):377–385.
   PubMed Web of Science ®Google Scholar
• Lyon R, Liebermann JA, Feiner J, Burch S. 2009. Relative efficacy of transcranial motor evoked potentials, mechanically-elicited electromyography and evoked EMG to assess nerve root function during sustained retraction in a porcine model. Spine. 34(16):E558–E564.
   PubMed Web of Science ®Google Scholar
• MacDonald DB, Stigsby B, Al Homoud I, Abalkhail T, Mokeem A. 2012. Utility of motor evoked potentials for intraoperative nerve root monitoring. J Clin Neurophysiol. 29(2):118–125.
   PubMed Web of Science ®Google Scholar
• Moed BR, Hartman MJ, Ahmad BK, Cody DD, Craig JG. 1999. Evaluation of intraoperative nerve-monitoring during insertion of iliosacral implant in an animal model. J Bone Joint Surg Am. 81(11):1529–1537.
   PubMedGoogle Scholar
• Padberg AM, Thuet ED. 2006. Intraoperative electrophysiologic monitoring: considerations for complex spinal surgery. Neurosurg Clin N Am. 17(3):205–226.
   PubMed Web of Science ®Google Scholar
• Raynor BL, Padberg AM, Lenke LG, Bridwell KH, Riew KD, Buchowski JM, Luhmann SJ. 2016. Failure of intraoperative monitoring to detect postoperative neurologic deficits. A 25-year experience in 12,375 spinal surgeries. Spine. 41(17):1387–1393.
   PubMed Web of Science ®Google Scholar
• Resnik DK, Choudhri TF, Dailey AT, Groff MW, Khoo L, Matz PG, Mummaneni P, Watters WC, Wang J, Walters BC, et al. 2005. American association of neurological surgeons/congress of neurological surgeons. Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 15: electrophysiological monitoring and lumbar fusion. J Neurosurg Spine. 2(6):725–732.
   PubMedGoogle Scholar
• Schirmer CM, Shils JL, Arle JE, Cosgrove GR, Dempsey PK, Tarlov E, Kim S, Martin CJ, Feltz C, Moul M, et al. 2011. Heuristic map of myotomal innervation in humans using direct intraoperative nerve root stimulation. J Neurosurg (Spine). 15(1):64–70.
   PubMed Web of Science ®Google Scholar
• Sharan A, Groff MW, Dailey AT, Ghogawala Z, Resnick DK, Watters WC, Mummaneni PV, Choudhri TF, Eck JC, Wang JC, et al. 2014. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 15: electrophysiological monitoring and lumbar fusion. J Neurosurg (Spine). 21(1):102–105.
   PubMed Web of Science ®Google Scholar
• Skinner S. 2015. The EMG–mEP-outcomes relationship: it’s complicated. J Clin Monit Comp. 29(5):541–542.
   PubMed Web of Science ®Google Scholar
• Suter M, Eggspuehel A, Jeszenszky D, Kleinstueck F, Fekete TF, Haschtmann D, Porchet F, Dvorak J. 2019. The impact and value of uni- and multimodal intraoperative neurophysiological monitoring (IONM) on neurological complications during spine surgery: a prospective study of 2728 patients. Eur Spine J. 28(3):599–610.
   PubMed Web of Science ®Google Scholar
• Tamkus A, Rice KS, Hoffman G. 2018. Transcranial motor evoked potential alarm criteria to predict foot drop injury during lumbosacral surgery. Spine (Phila Pa 1976). 43(4):E227–E233.
   PubMed Web of Science ®Google Scholar
• Ushirozako H, Yoshida G, Kobayashi S, Haegawa T, Yamato Y, Yasuda T, Banno T, Arima H, Oe S, Mihara Y, et al. 2018. Transcranial motor evoked potential monitoring for the detection of nerve root injury during adult spinal deformity surgery. Asian Spine J. 12(4):639–647. doi:10.31616/asj.2018.12.4.639.
   PubMedGoogle Scholar
• Wilent WB, Tesdahl EA, Harrop JS, Welch WC, Cannestra AF, Poelstra KA, Epplin-Zapf T, Stivali T, Cohen J, Sestokas AK. 2020. Utility of motor evoked potentials to diagnose and reduce lower extremity motor nerve root injuries during 4,386 extradural posterior lumbosacral spine procedures. Spine J. 20(2):191–198.
   PubMed Web of Science ®Google Scholar
• Wilent WB, Trott JM, Sestokas AK. 2021. Roadmap for motor evoked potential (MEP) monitoring for patients undergoing lumbar and lumbosacral spinal fusion procedures. Neurodiag J. 61(1):27–36.
   PubMedGoogle Scholar
• Wilkinson M, Ajoku U, Pederson K, McIntrye I, Zarrabian M. 2024. Identifying suspected volume conduction contamination of external anal sphincter motor evoked potentials in lumbosacral spine surgery. J Clin Neurophysiol. 41(2):169–174. doi:10.1097/WNP.0000000000000952.
   PubMed Web of Science ®Google Scholar
• Wilkinson MF, Houlden D. 2018. Letter: guidelines for the use of electrophysiological monitoring for surgery of the human spinal column and spinal cord. Neurosurgery. 83(2):E74–E75.
   PubMedGoogle Scholar
• Yoshida G, Ushirozako H, Machino M, Shigematsu H, Kawabata S, Yamada K, Kanchiku T, Fujiwara Y, Iwasaki H, Ando M, et al. 2022. Transcranial motor-evoked potentials for intraoperative nerve root monitoring during adult spinal deformity surgery: a prospective multicenter study. Spine. 47(22):1590–1598. doi:10.1097/BRS.0000000000004440.
   PubMed Web of Science ®Google Scholar