Clinical usefulness of assessing lumbar somatosensory evoked potentials in lumbar spinal stenosis

Clinical article

Xinyu Liu M.D.1,2, Shunsuke Konno M.D.1, Masabumi Miyamoto M.D.1, Yoshikazu Gembun M.D.1, Gen Horiguchi M.D.1, and Hiromoto Ito M.D.1
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  • 1 Department of Orthopedic Surgery, Nippon Medical School, Tokyo, Japan and
  • | 2 Department of Orthopedic Surgery, Qilu Hospital, Shandong University, Jinan, Shandong, People's Republic of China
Page Range:
71–78
Volume/Issue:
Volume 11: Issue 1
DOI link:
https://doi.org/10.3171/2009.3.SPINE08513
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Object

The aim of this retrospective study was to evaluate the clinical usefulness of assessing lumbar somatosensory evoked potentials (SSEPs) in central lumbar spinal stenosis (LSS).

Methods

The latencies of lumbar SSEPs were recorded in 40 patients with central LSS, including 16 men and 24 women. The mean age of the patients was 67.3 ± 7.4 years. The diagnosis was LSS in 23 cases and LSS associated with degenerative spondylolisthesis in 17 cases. The average duration of symptoms was 43.8 ± 51.2 months. Twenty-two cases had bilateral and 18 cases had unilateral leg symptoms. Thirty-seven cases were associated with neurogenic intermittent claudication and the mean walking distance of patients with this condition was 246.8 ± 232.7 m. The mean Japanese Orthopedic Association scale score, as well as the visual analog scale (VAS) scores of low-back pain, leg pain, and numbness, were 16.5 ± 3.5, 6.0 ± 2.5, 6.9 ± 2.1, and 7.8 ± 2.2, respectively. The minimal cross-sectional area of the dural sac on MR imaging was 0.44 ± 0.21 cm2. Thirty-nine cases of cervical spondylotic myelopathy without lumbar and peripheral neuropathy were chosen as the control group.

Results

The latencies of lumbar SSEPs in patients with LSS and in the control group were 23.0 ± 2.0 ms and 21.6 ± 1.9 ms, respectively. There was a statistically significant difference between the LSS and control groups (p < 0.05). The latency of lumbar SSEPs was significant correlated with the VAS score of leg numbness (p < 0.05). The latency of lumbar SSEPs in LSS was clearly delayed when the VAS score of leg numbness was ≥ 8 (p < 0.05).

Conclusions

Lumbar SSEPs are able to detect neurological deficit in the lumbar area effectively, and they can reflect part of the subjective severity of sensory disturbance (numbness) in LSS. Both lumbar SSEPs and VAS scores of leg numbness may be useful for clinical evaluation in patients with LSS.

Abbreviations used in this paper:

ADL = activities of daily living; CSM = cervical spondylotic myelopathy; JOA = Japanese Orthopaedic Association; LSS = lumbar spinal stenosis; NIC = neurogenic intermittent claudication; SSEP = somatosensory evoked potential; VAS = visual analog scale.

Volume 11: Issue 1 (Jul 2009)

in Journal of Neurosurgery: Spine
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