Intraoperative Loss of Tibialis Anterior Transcranial Electrical Motor Evoked Potentials Predicted Postoperative Footdrop.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 27751929.
- Also identified by DOI 10.1016/j.wneu.2016.10.036.
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Abstract
Footdrop secondary to L5 root injury is a rare complication associated with lumbar surgery. It is unclear whether intraoperative neuromonitoring can detect such an injury. A 54-year-old man who had had bilateral chronic L5 radiculopathy underwent L4-S1 lumbosacral decompression and fusion. During surgery, the patient lost transcranial electrical motor evoked potentials (tceMEPs) from the left tibialis anterior (TA) at the time of L5-S1 intervertebral cage placement. Neither intraoperative free-run electromyography nor somatosensory evoked potentials detected any changes. In addition, contralateral TA tceMEPs remained stable. Postoperatively, the patient presented with left-sided footdrop that has persisted for >1 year. Intraoperative TA tceMEPs could detect L5 root iatrogenic injury.
Medical subject headings
- Decompression, Surgical
- Gait Disorders, Neurologic
- Intraoperative Neurophysiological Monitoring
- Lumbar Vertebrae
- Spinal Fusion