Effects of nerve root retraction in lumbar discectomy.
The authors studied whether the amount of retraction pressure applied to a compromised nerve root during lumbar discectomy has an impact on intra- or postoperative outcome.


METHODS
The authors conducted a prospective analysis of 20 patients. There were 12 men and 12 women whose mean age (+/- standard deviation [SD]) was 42.25 years +/- 15 years (range 21-65 years). During intraoperative electromyography (EMG) monitoring, measurements were obtained during routine retraction of the affected nerve root by using a specially designed and constructed nerve root retractor connected to a reconfigured personal computer for this specific purpose. Follow-up results were assessed in the immediate postoperative period and at up to 1 year. The maximum measured force applied during random periods of time was 9.85 N/second (mean 6.95 +/- N/second [+/- SD]). The mean retraction time was 39.5 +/- 21 (SD). No intraoperative EMG-detected irritation was noted during or after routine retraction. In four of 20 patients, sensory changes occurred at the ipsilateral nerve root level, which resolved at the time of discharge.


CONCLUSIONS
The authors found that routine nerve root retraction does not cause nerve root irritation, as demonstrated by EMG monitoring, nor was patient outcome affected in this series.
Feltes
Carlos
C
Georgia Neurosurgical Institute, Medical Center of Central Georgia, Macon, Georgia 31201, USA. feltesmd@cs.com
Fountas
Kostas
K
Davydov
Rostislav
R
Dimopoulos
Vassilios
V
Robinson
Joe Sam
JS
D000328:Adult; D000368:Aged; D017586:Diskectomy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013126:Spinal Nerve Roots / Q000473:pathology / Q000601:surgery*