ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2024
Neurophysiological identification and differentiation between the motor and sensory roots in pediatric spinal cord lipoma surgery.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Effect of intravenous infusion of remimazolam versus propofol on intraoperative neurophysiological monitoring stability and postoperative neurological function in patients undergoing spinal surgery.American journal of translational research · 2026Article
- Effectiveness of conus lipoma surgery-a case series.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
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14 authors.
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Abstract
backgroundRadical resection of spinal cord lipomas reduces the rate of re-tethering. Current conventional neurophysiological mapping techniques are not able to differentiate between crucial motor nerve roots and sensory roots. Enhanced differentiation could contribute to complete resection. We present our experience with a double-train paradigm to differentiate between motor and sensory roots.
methodsIn children undergoing spinal cord lipoma resection, the double-train mapping paradigm was used with an inter-train interval of 60 ms. Given the longer recovery time due to the H-reflex, a single muscle response was presumed to be elicited from a sensory root, and a double muscle response from a motor root. The primary endpoint was postoperative neurological outcome and bladder function at discharge.
resultsWe included 8 children undergoing 10 lipoma resections between 2016 and 2023. Double-train mapping was used in all cases. Motor and sensory roots were clearly differentiated in 6 cases and altered the course of surgery in 4 cases. Post-surgery, no sensory and motor function worsened within 3 months. Bladder function was stable in six and improved in two children. In two patients, bladder function worsened slightly at 3 months and 6 months, at which point one patient was re-operated on for re-tethering.
conclusionIntraoperative mapping with the double-train paradigm reliably differentiated between motor and sensory nerve roots. Informing the surgeon on the specific function of a tethering root may help to maximize resection without risking major neurological deficits.
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