Study of Lower Extremity Myotomes by Compound Muscle Action Potential.

概要

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The lumbosacral plexus innervation is variable, making the diagnosis of lumbar spinal disease according to lower extremity symptoms complicated. We investigated lower extremity myotomes by recording the compound muscle action potential (CMAP) during lumbar spinal surgery in six L4 roots, twenty-four L5 roots and fourteen S1 roots. At L4 root, innervation to only Quadriceps is 33%, to Quadriceps and Tibialis Anterior is 50%, to Quadriceps, Tibialis Anterior and Gastrocnemius is 17%. At L5 root, the innervation to only Tibialis Anterior is 41%, to Tibialis Anterior and Gastrocnemius is 59%. At S1 root, the innervation to only Gastrocnemius is 57%, to Gastrocnemius and Tibialis Anterior is 43%. Knowledge of the relationship of L4 root to Quadriceps, L5 root to Tibialis Anterior, S1 root to Gastrocnemius are required. 3 out of 9 cases also had different innervation between their right and left sides.