The reference intervals of intraoperative posterior tibial nerve somatosensory evoked potentials |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan;2. Sports Medicine and Joint Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi, Chiba, 274-0822, Japan;3. Tokyo Sports & Orthopaedic Clinic, 4-29-9 Kami-ikebukuro, Toshima, Tokyo, 170-0012, Japan;1. Department of Orthopedic Surgery, Fuzhou Second Hospital Affiliated to Xiamen University, The Teaching Hospital of Fujian Medical University, Fuzhou, Fujian, China;2. School of Medicine, Xiamen University, Xiamen, Fujian, China;3. Department of Orthopedic Surgery, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China;4. Xiamen University, Xiamen, Fujian, China;1. Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan;2. Department of Bone and Joint Biomaterial Research, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan;3. Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, 6-3-1 Niijuku, Katsushika-ku, Tokyo, 125-8585, Japan;1. Department of Orthopaedic Surgery, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan;2. Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan;3. Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan;4. Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan;5. Department of Orthopedic Surgery, Keio University, School of Medicine, Tokyo, Japan;6. Department of Orthopedic Surgery, National Hospital Organization Okayama Medical Center, Okayama, Japan;7. Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan;8. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan;9. Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan;10. Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan;11. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan;12. Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan;13. Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan;14. Department of Orthopedics, Jichi Medical University, Jichi, Japan;15. Department of Orthopedic Surgery, University of Yamanashi, Yamanashi, Japan;p. Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, Tokai, Japan;q. Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan;r. Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University, Tohoku, Japan;s. Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan;t. Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), Tokyo, Japan;1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;2. Department of Orthopaedic Surgery, Kyushu University Beppu Hospital, Beppu, Oita, Japan |
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| Abstract: | BackgroundA reference interval exists for posterior tibial nerve somatosensory evoked potentials (PTN-SEPs) in awake. However, the reference interval for intraoperative- PTN-SEPs (I-PTN-SEPs) remains unclear. As a substitute for PTN-SEPs in awake, we considered I-PTN-SEPs can provide functional information about the dorsal somatosensory system. No report evaluated the physiologic and analytical issues in the measurement of I-PTN-SEPs. We investigated the sources of variation and reference intervals for I-PTN-SEPs.MethodsWe studied 143 patients with unilateral radiculopathy and without neurologic deficit who underwent surgery. Stimulation was delivered to the PTN at the ankle. The scalp recording electrode was placed at the Cz with a reference electrode located on the forehead at the Fz. SEPs were recorded from patients during electrical stimulation of the I-PTN.ResultsP1 and N1 latencies showed significant positive linear correlations with age (P1 latency = 36.52 + 0.0814 × age, P = 0.00003; N1 latency = 46.21 + 0.081 × age, P = 0.00022), and body height (P1 latency = 16.94 + 14.91 × body height, P = 0.00000; N1 latency = 25.42 + 15.64 × body height, P = 0.00002). In contrast, I-PTN-SEPs amplitude showed no correlation with age or body height. The 95% confidence interval for I-PTN-SEPs amplitude, or the reference interval, was determined as 0.31–5.91 μV.ConclusionsThe lower normal limit value was 0.31 μV, and this reference interval may be useful to evaluate function of the posterior funiculus, such that as during surgery for patients with intramedullary tumor. |
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