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Combined measurement of nerve root blood flow and electrophysiological values: intraoperative straight-leg-raising test for lumbar disc herniation.
MedLine Citation:
PMID:  20634784     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
STUDY DESIGN: A total of 15 patients with lumbar disc herniation at the L5-S1 disc level who underwent microendoscopic discectomy were examined. The nerve root blood flow and electrophysiological values were measured during an intraoperative straight-leg-raising (SLR) test.
OBJECTIVE: To investigate the relationships between nerve root blood flow changes and the electrophysiological values during an intraoperative SLR test.
SUMMARY OF THE BACKGROUND DATA: It is unknown how the electrophysiological values are affected by nerve root blood flow changes during an SLR test.
METHODS: We measured S1 nerve root blood flow and electrophysiologically evaluated the nerve root using the compound muscle action potentials (CMAPs) from the gastrocnemius muscle after S1 nerve root stimulation during an intraoperative SLR test. Subsequently, we analyzed the relationships between the nerve root blood flow changes and the electrophysiological values.
RESULTS: Before discectomy, there were sharp decreases in the nerve root blood flow after 1 and 3 minutes of the SLR test (P < 0.001), and the amplitudes of the CMAPs deteriorated significantly (P < 0.001). Significant correlations were found between the decrease ratio for the nerve root blood flow during the SLR test and the deterioration ratio for the amplitude of the CMAPs. After discectomy, the blood flow increased significantly (P = 0.001). When the SLR test was performed again, the blood flow showed no significant decreases. The average amplitudes of the CMAPs were significantly ameliorated (P < 0.01). When the SLR test was performed again, no significant differences were found for the average amplitudes after 1 and 3 minutes of the test.
CONCLUSION: Significant correlations were found between the decrease ratio for the nerve root blood flow and the deterioration ratio for the amplitude of the CMAPs. The present results demonstrate that temporary ischemic changes in the nerve root cause transient conduction disturbances.
Authors:
Yoshihiro Takamori; Jun Arimizu; Teruaki Izaki; Masatoshi Naito; Tatsuki Kobayashi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  36     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  57-62     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Fukuoka University, Fukuoka, Japan. davi_1003@yahoo.co.jp
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