3-10-01. Intraoperative detection using transcranial electrical stimulated muscle evoked potentials (TcMsEP) of postoperative upper extremity palsies after cervical spine surgery – The difference between C5 and C7 palsies. Issue 6 (June 2017)

• Record Type: Journal Article
• Authors: Fujiwara, Yasushi; Manabe, Hideki; Izumi, Bunichiro; Shima, Takayuki; Harada, Takahiro; Arakawa, Yasuo
• Is Part Of: Clinical neurophysiology. Volume 128:Issue 6(2017:Jun.)
• Page Start: e169
• Publication Date: 2017-06
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2017.03.029
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Although intraoperative TcMsEP monitoring is useful to detect postoperative palsy following spine surgeries, a controversy remains in the detection of segmental upper extremity palsies. In this study, we investigated the difference between C5 and C7 palsies after cervical spine surgeries that were detected by TcMsEP monitoring. This study included 5 patients with C5 palsies and 3 with C7 palsies. TcMsEP monitoring was performed in the biceps brachii, triceps brachii, abductor digiti minimi, and abductor halluces. A more than 50% decrease in the wave amplitude was defined as an alarm criterion. Postoperative C5 palsies were defined as muscle weakness in deltoid and biceps and C7 palsies were defined as muscle weakness in triceps. C5 palsy cases showed segmental wave decrease in biceps and triceps waves although there was no palsy in triceps muscle. In contrast, C7 palsy cases showed segmental wave decrease in Triceps without no wave decrease in the other muscles. Our results showed unique difference of wave amplitude changes between C5 and C7 palsies, especially in the triceps muscles. We speculated that the difference of innervation of the biceps and triceps muscles might cause the contradiction. Further examination will be necessary.