Document Detail


Electrophysiological Study for Nerve Root Entrapment in Patients with Isthmic Spondylolisthesis.
MedLine Citation:
PMID:  24165009     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
STUDY DESIGN:: A case series study.
OBJECTIVE:: To investigate the electrophysiological location of nerve root entrapment in patients with isthmic spondylolisthesis.
SUMMARY OF BACKGROUND DATA:: Although the lesion of the nerve root in patients with isthmic spondylolisthesis has been thought to be located at the pars interarticularis due to proliferation of fibrous cartilage, there is no electrophysiological study in relation to this accomplished fact.
METHODS:: We performed an electrophysiological study in 12 patients with isthmic spondylolisthesis during surgery. All patients presented with low-grade isthmic spondylolisthesis and unilateral radiculopathy, and underwent single-level posterior lumbar interbody fusion (PLIF) with instrumentation. After a total facetectomy, nerve root action potentials were recorded by stimulating the ipsilateral peroneal nerve at the popliteal fossa. Four needle electrodes were inserted into the affected nerve root at the intraspinal canal, pars interarticularis, disc level, and extra lateral to the disc. The waveforms that showed either a positive waveform pattern or polyphasic waveform pattern were regarded as abnormal potentials. We also confirmed surgical records and preoperative images to investigate the relationship to the electrophysiological findings.
RESULTS:: An abnormal waveform pattern was demonstrated at the pars interarticularis in six patients, at the disc level in five, and at the extra lateral site in one. Based on the electrophysiological findings of this study, the nerve root lesion was not always found on only the pars interarticularis in patients with isthmic spondylolisthesis. A relationship between the electrophysiological findings and surgical records or preoperative images was not found.
CONCLUSIONS:: The electrophysiological investigation in this study shows that the nerve root entrapment in patients with isthmic spondylolisthesis occurs not only at the pars interarticularis but distal to the isthmus. This study suggests the possibility of insufficiency of decompression only at the pars interarticularis for patients with isthmic spondylolisthesis.
Authors:
Masahiro Morita; Akira Miyauchi; Shinya Okuda; Takenori Oda; Motoki Iwasaki
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-27
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  -     ISSN:  1539-2465     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Department of Orthopaedic Surgery, Izumi Municipal Hospital, 4-10-10 Fuchu Izumi City Osaka, 594-0071, Japan †Miyauchi Orthopaedic Surgery, 5-12-8 Misaki, Suminoeku, Osaka City Osaka, 559-0013, Japan ‡Department of Orthopaedic Surgery, Osaka Rosai Hosipital, 1179-3 Nagasone Kitaku Sakai City Osaka, 591-8025, Japan §Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka Suita city Osaka, 565-0871, Japan.
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