Author/Editor     Deletis, V; Vodušek, DB; Abbott, R; Epstein, FJ; Turndorf, H
Title     Intraoperative monitoring of the dorsal sacral roots: minimizing the risk of iatrogenic micturition disorders
Type     članek
Source     Neurosurgery
Vol. and No.     Letnik 30, št. 1
Publication year     1992
Volume     str. 72-5
Language     eng
Abstract     In 31 children (age, 2-17 years) and 1 adult, individual dorsal root action potentials (DRAPs) from the S1-S3 roots were recorded intraoperatively after electrical stimulation of the dorsal penile or clitoral nerves, in preparation for surgery within the cauda equina. In most patients, pudendal afferent activity was present in S2 and S3 bilaterally; in some, the afferent activity was confined to a single root bilaterally, and in one, to a single root on one side. Dorsal root action potentials of small amplitude were recorded from S1 in 15 patients, although in no patient was S1 the primary carrier of these afferents. No lesion of the roots or rootlets carrying significant afferent activity was created during the rhizotomy, and no dysfunction in micturition resulted. We propose that the neurophysiological identification of roots and rootlets carrying afferent activity from the penile or clitoral nerves allows for rhizotomy of the S2 roots with the least possible risk of postoperative micturition and sexual dysfunction.
Descriptors     IATROGENIC DISEASE
MONITORING, PHYSIOLOGIC
SPINAL NERVE ROOTS
URINATION DISORDERS
ADOLESCENCE
CEREBRAL PALSY
CHILD
CHILD, PRESCHOOL
INTRAOPERATIVE PERIOD
LUMBOSACRAL REGION
SPINAL NERVE ROOTS