Biomechanical Response in the Ankle to Stimulation of Lumbosacral Nerve Roots with Spiral Cuff Multielectrode : Preliminary Study

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概要

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• Biomechanical response in the ankle to tetanic stimulation of the lumbosacral root was investigated to assess the potential for lower limb functional neurostimulation. Myotomal response in the leg was measured as the three-dimensional isometric torque in the ankle after extradural tetanic stimulation of the L3-Sl roots exposed surgically for herniated disc removal in five patients. The cuff multielectrode was employed to investigate functional topography of the roots by monopolar, bipolar, and tripolar electrode configurations. Four response patterns in the direction of three-dimensional torque vectorswere observed. The L-5 and S-1 roots had the same response pattern, but S-1 roots produced stronger torques. Dorsiflexion torque was not obtained by stimulation of L-5 roots despite coactivation of the tibial anterior and peroneal muscles. Dorsiflexion torques were produced only by stimulating the L-4 roots. More selective bipolar and tripolar stimulations recruited force at higher threshold, and lessgain. Additionally, some muscles were not activated by tripolar stimulation of the same root. In one L-4 root, the torque at lower electrical threshold was replaced by inverse torque at higher threshold, providing indirect evidence that different muscles may have motoneuron populations that differ indiameter or location within the root. Although dorsiflexion and plantarflexion torques are functional per se, they are accompanied by foot inversion and leg rotation torques (as well as proximal musclecontractions). Further experimental investigations on direct extradural stimulation of lumbosacral roots, either single or in combination, are recommended to explore the potential of lumbosacral nerve root stimulation for restoration of leg function.

• 日本脳神経外科学会の論文
• 1999-09-15

著者

• Bosnjak Roman

  Department Of Neurosurgery University Hospital Center

• DOLENC Vinko

  Department of Neurosurgery, University Hospital Center

• KARALJ Alojz

  Faculty of Electrical Engineering, University of Ljubljana

• Dolenc Vinko

  Department Of Neurosurgery University Hospital Center

• Karalj Alojz

  Faculty Of Electrical Engineering University Of Ljubljana

関連論文

• Development of a New Irrigation Sucker for Microneurosurgery : Technical Note
• Neurophysiological Monitoring of S1 Root Function During Microsurgical Posterior Discectomy Using H-Reflex and Spinal Nerve Root Potentials
• Electrical Thresholds for Biomechanical Response in the Ankle to Direct Stimulation of Spinal Roots L4, L5, and S1 : Implications for Intraoperative Pedicle Screw Testing
• Biomechanical Response in the Ankle to Stimulation of Lumbosacral Nerve Roots with Spiral Cuff Multielectrode : Preliminary Study

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