Intraoperative Loss of Tibialis Anterior Transcranial Electrical Motor Evoked Potentials Predicted Postoperative Footdrop

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• 作者：Qing Yue¹ ; ² ; ^{qyue@bloomu.edu} ; Tyson Hale¹ ; ² ; Aaron Knecht¹ ; Jennifer Laidacker¹
• 关键词：Electromyography (EMG) ; Footdrop ; Somatosensory evoked potential (SSEP) ; Tibialis anterior (TA) ; Transcranial electrical motor evoked potential (tceMEP)
• 刊名：World Neurosurgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：97
• 期：Complete
• 页码：755.e1-755.e3
• 全文大小：909 K
• 卷排序：97

文摘

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.Case DescriptionA 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.ConclusionsIntraoperative TA tceMEPs could detect L5 root iatrogenic injury.