Evidence map›Paper›PMID 32577878›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2020

Frequency distribution in intraoperative stimulation-evoked EMG responses during selective dorsal rhizotomy in children with cerebral palsy-part 1: clinical setting and neurophysiological procedure.

Simone Wolter, Claudia Spies, John H Martin, Matthias Schulz, Akosua Sarpong-Bengelsdorf, Joachim Unger, Ulrich-W Thomale, Theodor Michael, James F Murphy, Hannes Haberl

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03079362 (SDR Monitoring in Children With Cerebral Palsy - a Retrospective Cohort Study), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03079362 completednot on this map

SDR Monitoring in Children With Cerebral Palsy - a Retrospective Cohort Study

TypeobservationalSponsorCharite University, Berlin, GermanyRan2007 to 2015Enrolled148ConditionsCerebral Palsy
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. History of Dorsal Rhizotomy for Spasticity.Advances and technical standards in neurosurgery · 2025
    Review
  2. Review
  3. Functional Posterior Rhizotomy with the Use of Intraoperative Neurophysiology.Advances and technical standards in neurosurgery · 2025
    Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Simone WolterDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany. simone.wolter@charite.de.ORCID 0000-0001-7741-8761
Claudia SpiesDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany.
John H MartinDepartment of Molecular, Cellular, and Basic Medical Sciences, Center for Discovery and Innovation, City University of New York School of Medicine, New York, NY, USA.
Matthias SchulzDivision of Pediatric Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany.
Akosua Sarpong-BengelsdorfCenter for Chronically Sick Children (SPZ), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany.
Joachim UngerDepartment of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany.
Ulrich-W ThomaleDivision of Pediatric Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353, Berlin, Germany.
Theodor MichaelDivision of Pediatric Neurosurgery, Universitätsklinikum Bonn, 53127, Bonn, Germany.
James F MurphyDahlem Research School, Freie Universität Berlin, 14195, Berlin, Germany.
Hannes HaberlDivision of Pediatric Neurosurgery, Universitätsklinikum Bonn, 53127, Bonn, Germany.
Humboldt-Universität zu Berlin · DEUniversity Hospital Bonn · DEFreie Universität Berlin · DEThe Graduate Center, CUNY · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSelective dorsal rhizotomy (SDR) consists of microsurgical partial deafferentation of sensory nerve roots (L1-S2). It is primarily used today in decreasing spasticity in young cerebral palsy (CP) patients. Intraoperative monitoring (IOM) is an essential part of the surgical decision-making process, aimed at improving functional results. The role played by SDR-IOM is examined, while realizing that connections between complex EMG responses to nerve-root stimulation and a patient's individual motor ability remain to be clarified.

methodsWe conducted this retrospective study, analyzing EMG responses in 146 patients evoked by dorsal-root and rootlet stimulation, applying an objective response-classification system, and investigating the prevalence and distribution of the assessed grades. Part1 describes the clinical setting and SDR procedure, reintroduced in Germany by the senior author in 2007.

resultsStimulation-evoked EMG response patterns revealed significant differences along the segmental levels. More specifically, a comparison of grade 3+4 prevalence showed that higher-graded rootlets were more noticeable at lower nerve root levels (L5, S1), resulting in a typical rostro-caudal anatomical distribution.

conclusionsIn view of its prophylactic potential, SDR should be carried out at an early stage in all CP patients suffering from severe spasticity. It is particularly effective when used as an integral part of a coordinated, comprehensive spasticity program in which a team of experts pool their information. The IOM findings pertaining to the anatomical grouping of grades could be of potential importance in adjusting the SDR-IOM intervention to suit the specific individual constellation, pending further validation.

trial registrationClinicalTrials.gov ID: NCT03079362.

Indexed as

Cerebral PalsyRhizotomyChildGermanyHumansMuscle SpasticityRetrospective StudiesSpinal Nerve RootsTreatment OutcomeIntraoperative neuromonitoringLumbosacral level differencesRostro-caudal anatomical distributionSDRStimulation-evoked EMG responseThreshold intensity

Identifiers

PMID32577878
PMCPMC7434802
OpenAlexW3037395466

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.