Neurophysiological monitoring for the nucleus caudalis dorsal root entry zone operation

Aatif M. Husain, Sharon L. Elliott, John P. Gorecki, Kim Burchiel, Frank Hsu, Björn Meyerson, Donlin M. Long

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE: The purpose of this report is to describe a neurophysiological monitoring technique that can decrease the incidence of complications while maintaining the effectiveness of the nucleus caudalis dorsal root entry zone (DREZ) operation. METHODS: Needle electrodes were used to stimulate the supraorbital, infraorbital, mental, and median nerves after the nucleus caudalis was surgically exposed. The DREZ electrode was used to record responses from the various areas in and near the nucleus. The target site was localized. Before lesioning, the site was stimulated with the DREZ electrode and electromyographic activation was sought. If no activation was observed, a lesion was made. RESULTS: Five patients underwent a total of seven nucleus caudalis DREZ procedures with complete neurophysiological monitoring. The mean number of lesions per procedure in this series was 5.4. Six procedures (86%) resulted in immediate pain relief, and five (71%) produced persistent benefit after a mean follow-up period of 12 months. Only one patient (20%) (one of seven procedures) who underwent a unilateral DREZ procedure had ataxia, which resolved within a few days. No complications were noted at follow-up. CONCLUSION: Despite patients in this series receiving fewer lesions, the efficacy of the DREZ operation was comparable to that reported in earlier studies. There were fewer complications when neurophysiological monitoring was used. Such monitoring should be considered for nucleus caudalis DREZ operations.

Original languageEnglish (US)
Pages (from-to)822-828
Number of pages7
JournalNeurosurgery
Volume50
Issue number4
DOIs
StatePublished - Apr 1 2002
Externally publishedYes

Fingerprint

Neurophysiological Monitoring
Spinal Nerve Roots
Electrodes
Median Nerve
Ataxia
Needles
Pain

Keywords

  • Dorsal root entry zone operation
  • Electromyographic monitoring
  • Neurophysiological monitoring
  • Nucleus caudalis
  • Trigeminal evoked potentials

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Husain, A. M., Elliott, S. L., Gorecki, J. P., Burchiel, K., Hsu, F., Meyerson, B., & Long, D. M. (2002). Neurophysiological monitoring for the nucleus caudalis dorsal root entry zone operation. Neurosurgery, 50(4), 822-828. https://doi.org/10.1097/00006123-200204000-00025

Neurophysiological monitoring for the nucleus caudalis dorsal root entry zone operation. / Husain, Aatif M.; Elliott, Sharon L.; Gorecki, John P.; Burchiel, Kim; Hsu, Frank; Meyerson, Björn; Long, Donlin M.

In: Neurosurgery, Vol. 50, No. 4, 01.04.2002, p. 822-828.

Research output: Contribution to journalArticle

Husain, AM, Elliott, SL, Gorecki, JP, Burchiel, K, Hsu, F, Meyerson, B & Long, DM 2002, 'Neurophysiological monitoring for the nucleus caudalis dorsal root entry zone operation', Neurosurgery, vol. 50, no. 4, pp. 822-828. https://doi.org/10.1097/00006123-200204000-00025
Husain, Aatif M. ; Elliott, Sharon L. ; Gorecki, John P. ; Burchiel, Kim ; Hsu, Frank ; Meyerson, Björn ; Long, Donlin M. / Neurophysiological monitoring for the nucleus caudalis dorsal root entry zone operation. In: Neurosurgery. 2002 ; Vol. 50, No. 4. pp. 822-828.
@article{545533fc43224695907df19d37e17280,
title = "Neurophysiological monitoring for the nucleus caudalis dorsal root entry zone operation",
abstract = "OBJECTIVE: The purpose of this report is to describe a neurophysiological monitoring technique that can decrease the incidence of complications while maintaining the effectiveness of the nucleus caudalis dorsal root entry zone (DREZ) operation. METHODS: Needle electrodes were used to stimulate the supraorbital, infraorbital, mental, and median nerves after the nucleus caudalis was surgically exposed. The DREZ electrode was used to record responses from the various areas in and near the nucleus. The target site was localized. Before lesioning, the site was stimulated with the DREZ electrode and electromyographic activation was sought. If no activation was observed, a lesion was made. RESULTS: Five patients underwent a total of seven nucleus caudalis DREZ procedures with complete neurophysiological monitoring. The mean number of lesions per procedure in this series was 5.4. Six procedures (86{\%}) resulted in immediate pain relief, and five (71{\%}) produced persistent benefit after a mean follow-up period of 12 months. Only one patient (20{\%}) (one of seven procedures) who underwent a unilateral DREZ procedure had ataxia, which resolved within a few days. No complications were noted at follow-up. CONCLUSION: Despite patients in this series receiving fewer lesions, the efficacy of the DREZ operation was comparable to that reported in earlier studies. There were fewer complications when neurophysiological monitoring was used. Such monitoring should be considered for nucleus caudalis DREZ operations.",
keywords = "Dorsal root entry zone operation, Electromyographic monitoring, Neurophysiological monitoring, Nucleus caudalis, Trigeminal evoked potentials",
author = "Husain, {Aatif M.} and Elliott, {Sharon L.} and Gorecki, {John P.} and Kim Burchiel and Frank Hsu and Bj{\"o}rn Meyerson and Long, {Donlin M.}",
year = "2002",
month = "4",
day = "1",
doi = "10.1097/00006123-200204000-00025",
language = "English (US)",
volume = "50",
pages = "822--828",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Neurophysiological monitoring for the nucleus caudalis dorsal root entry zone operation

AU - Husain, Aatif M.

AU - Elliott, Sharon L.

AU - Gorecki, John P.

AU - Burchiel, Kim

AU - Hsu, Frank

AU - Meyerson, Björn

AU - Long, Donlin M.

PY - 2002/4/1

Y1 - 2002/4/1

N2 - OBJECTIVE: The purpose of this report is to describe a neurophysiological monitoring technique that can decrease the incidence of complications while maintaining the effectiveness of the nucleus caudalis dorsal root entry zone (DREZ) operation. METHODS: Needle electrodes were used to stimulate the supraorbital, infraorbital, mental, and median nerves after the nucleus caudalis was surgically exposed. The DREZ electrode was used to record responses from the various areas in and near the nucleus. The target site was localized. Before lesioning, the site was stimulated with the DREZ electrode and electromyographic activation was sought. If no activation was observed, a lesion was made. RESULTS: Five patients underwent a total of seven nucleus caudalis DREZ procedures with complete neurophysiological monitoring. The mean number of lesions per procedure in this series was 5.4. Six procedures (86%) resulted in immediate pain relief, and five (71%) produced persistent benefit after a mean follow-up period of 12 months. Only one patient (20%) (one of seven procedures) who underwent a unilateral DREZ procedure had ataxia, which resolved within a few days. No complications were noted at follow-up. CONCLUSION: Despite patients in this series receiving fewer lesions, the efficacy of the DREZ operation was comparable to that reported in earlier studies. There were fewer complications when neurophysiological monitoring was used. Such monitoring should be considered for nucleus caudalis DREZ operations.

AB - OBJECTIVE: The purpose of this report is to describe a neurophysiological monitoring technique that can decrease the incidence of complications while maintaining the effectiveness of the nucleus caudalis dorsal root entry zone (DREZ) operation. METHODS: Needle electrodes were used to stimulate the supraorbital, infraorbital, mental, and median nerves after the nucleus caudalis was surgically exposed. The DREZ electrode was used to record responses from the various areas in and near the nucleus. The target site was localized. Before lesioning, the site was stimulated with the DREZ electrode and electromyographic activation was sought. If no activation was observed, a lesion was made. RESULTS: Five patients underwent a total of seven nucleus caudalis DREZ procedures with complete neurophysiological monitoring. The mean number of lesions per procedure in this series was 5.4. Six procedures (86%) resulted in immediate pain relief, and five (71%) produced persistent benefit after a mean follow-up period of 12 months. Only one patient (20%) (one of seven procedures) who underwent a unilateral DREZ procedure had ataxia, which resolved within a few days. No complications were noted at follow-up. CONCLUSION: Despite patients in this series receiving fewer lesions, the efficacy of the DREZ operation was comparable to that reported in earlier studies. There were fewer complications when neurophysiological monitoring was used. Such monitoring should be considered for nucleus caudalis DREZ operations.

KW - Dorsal root entry zone operation

KW - Electromyographic monitoring

KW - Neurophysiological monitoring

KW - Nucleus caudalis

KW - Trigeminal evoked potentials

UR - http://www.scopus.com/inward/record.url?scp=0036556265&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036556265&partnerID=8YFLogxK

U2 - 10.1097/00006123-200204000-00025

DO - 10.1097/00006123-200204000-00025

M3 - Article

VL - 50

SP - 822

EP - 828

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 4

ER -