Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy
Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR,...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Fukuhara, Toru [verfasserIn] Nakatsu, Daisuke [verfasserIn] Namba, Yoichiro [verfasserIn] Yamadori, Ichiro [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2011 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Child's nervous system - Berlin : Springer, 1985, 27(2011), 9 vom: 19. Apr., Seite 1453-1458 |
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| Übergeordnetes Werk: |
volume:27 ; year:2011 ; number:9 ; day:19 ; month:04 ; pages:1453-1458 |
| Links: |
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| DOI / URN: |
10.1007/s00381-011-1462-5 |
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| Katalog-ID: |
SPR00459777X |
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| 245 | 1 | 0 | |a Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy |
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| 520 | |a Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. This finding should be reminded as a precaution when considering nonselective dorsal rhizotomy, especially, for children who are expected to stand up after the surgery. | ||
| 650 | 4 | |a Cerebral palsy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Electron microscope |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Peripheral neuropathy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Selective dorsal rhizotomy |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Nakatsu, Daisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Namba, Yoichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Yamadori, Ichiro |e verfasserin |4 aut | |
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10.1007/s00381-011-1462-5 doi (DE-627)SPR00459777X (SPR)s00381-011-1462-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl 44.67 bkl Fukuhara, Toru verfasserin aut Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. This finding should be reminded as a precaution when considering nonselective dorsal rhizotomy, especially, for children who are expected to stand up after the surgery. Cerebral palsy (dpeaa)DE-He213 Electron microscope (dpeaa)DE-He213 Peripheral neuropathy (dpeaa)DE-He213 Selective dorsal rhizotomy (dpeaa)DE-He213 Nakatsu, Daisuke verfasserin aut Namba, Yoichiro verfasserin aut Yamadori, Ichiro verfasserin aut Enthalten in Child's nervous system Berlin : Springer, 1985 27(2011), 9 vom: 19. Apr., Seite 1453-1458 (DE-627)254639054 (DE-600)1463024-2 1433-0350 nnns volume:27 year:2011 number:9 day:19 month:04 pages:1453-1458 https://dx.doi.org/10.1007/s00381-011-1462-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE 44.67 ASE AR 27 2011 9 19 04 1453-1458 |
| spelling |
10.1007/s00381-011-1462-5 doi (DE-627)SPR00459777X (SPR)s00381-011-1462-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl 44.67 bkl Fukuhara, Toru verfasserin aut Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. This finding should be reminded as a precaution when considering nonselective dorsal rhizotomy, especially, for children who are expected to stand up after the surgery. Cerebral palsy (dpeaa)DE-He213 Electron microscope (dpeaa)DE-He213 Peripheral neuropathy (dpeaa)DE-He213 Selective dorsal rhizotomy (dpeaa)DE-He213 Nakatsu, Daisuke verfasserin aut Namba, Yoichiro verfasserin aut Yamadori, Ichiro verfasserin aut Enthalten in Child's nervous system Berlin : Springer, 1985 27(2011), 9 vom: 19. Apr., Seite 1453-1458 (DE-627)254639054 (DE-600)1463024-2 1433-0350 nnns volume:27 year:2011 number:9 day:19 month:04 pages:1453-1458 https://dx.doi.org/10.1007/s00381-011-1462-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE 44.67 ASE AR 27 2011 9 19 04 1453-1458 |
| allfields_unstemmed |
10.1007/s00381-011-1462-5 doi (DE-627)SPR00459777X (SPR)s00381-011-1462-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl 44.67 bkl Fukuhara, Toru verfasserin aut Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. This finding should be reminded as a precaution when considering nonselective dorsal rhizotomy, especially, for children who are expected to stand up after the surgery. Cerebral palsy (dpeaa)DE-He213 Electron microscope (dpeaa)DE-He213 Peripheral neuropathy (dpeaa)DE-He213 Selective dorsal rhizotomy (dpeaa)DE-He213 Nakatsu, Daisuke verfasserin aut Namba, Yoichiro verfasserin aut Yamadori, Ichiro verfasserin aut Enthalten in Child's nervous system Berlin : Springer, 1985 27(2011), 9 vom: 19. Apr., Seite 1453-1458 (DE-627)254639054 (DE-600)1463024-2 1433-0350 nnns volume:27 year:2011 number:9 day:19 month:04 pages:1453-1458 https://dx.doi.org/10.1007/s00381-011-1462-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE 44.67 ASE AR 27 2011 9 19 04 1453-1458 |
| allfieldsGer |
10.1007/s00381-011-1462-5 doi (DE-627)SPR00459777X (SPR)s00381-011-1462-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl 44.67 bkl Fukuhara, Toru verfasserin aut Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. This finding should be reminded as a precaution when considering nonselective dorsal rhizotomy, especially, for children who are expected to stand up after the surgery. Cerebral palsy (dpeaa)DE-He213 Electron microscope (dpeaa)DE-He213 Peripheral neuropathy (dpeaa)DE-He213 Selective dorsal rhizotomy (dpeaa)DE-He213 Nakatsu, Daisuke verfasserin aut Namba, Yoichiro verfasserin aut Yamadori, Ichiro verfasserin aut Enthalten in Child's nervous system Berlin : Springer, 1985 27(2011), 9 vom: 19. Apr., Seite 1453-1458 (DE-627)254639054 (DE-600)1463024-2 1433-0350 nnns volume:27 year:2011 number:9 day:19 month:04 pages:1453-1458 https://dx.doi.org/10.1007/s00381-011-1462-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE 44.67 ASE AR 27 2011 9 19 04 1453-1458 |
| allfieldsSound |
10.1007/s00381-011-1462-5 doi (DE-627)SPR00459777X (SPR)s00381-011-1462-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl 44.67 bkl Fukuhara, Toru verfasserin aut Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. This finding should be reminded as a precaution when considering nonselective dorsal rhizotomy, especially, for children who are expected to stand up after the surgery. Cerebral palsy (dpeaa)DE-He213 Electron microscope (dpeaa)DE-He213 Peripheral neuropathy (dpeaa)DE-He213 Selective dorsal rhizotomy (dpeaa)DE-He213 Nakatsu, Daisuke verfasserin aut Namba, Yoichiro verfasserin aut Yamadori, Ichiro verfasserin aut Enthalten in Child's nervous system Berlin : Springer, 1985 27(2011), 9 vom: 19. Apr., Seite 1453-1458 (DE-627)254639054 (DE-600)1463024-2 1433-0350 nnns volume:27 year:2011 number:9 day:19 month:04 pages:1453-1458 https://dx.doi.org/10.1007/s00381-011-1462-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE 44.67 ASE AR 27 2011 9 19 04 1453-1458 |
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Enthalten in Child's nervous system 27(2011), 9 vom: 19. Apr., Seite 1453-1458 volume:27 year:2011 number:9 day:19 month:04 pages:1453-1458 |
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Enthalten in Child's nervous system 27(2011), 9 vom: 19. Apr., Seite 1453-1458 volume:27 year:2011 number:9 day:19 month:04 pages:1453-1458 |
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Cerebral palsy Electron microscope Peripheral neuropathy Selective dorsal rhizotomy |
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Fukuhara, Toru @@aut@@ Nakatsu, Daisuke @@aut@@ Namba, Yoichiro @@aut@@ Yamadori, Ichiro @@aut@@ |
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However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. 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|
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Fukuhara, Toru |
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Fukuhara, Toru ddc 610 bkl 44.90 bkl 44.67 misc Cerebral palsy misc Electron microscope misc Peripheral neuropathy misc Selective dorsal rhizotomy Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy |
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610 ASE 44.90 bkl 44.67 bkl Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy Cerebral palsy (dpeaa)DE-He213 Electron microscope (dpeaa)DE-He213 Peripheral neuropathy (dpeaa)DE-He213 Selective dorsal rhizotomy (dpeaa)DE-He213 |
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ddc 610 bkl 44.90 bkl 44.67 misc Cerebral palsy misc Electron microscope misc Peripheral neuropathy misc Selective dorsal rhizotomy |
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ddc 610 bkl 44.90 bkl 44.67 misc Cerebral palsy misc Electron microscope misc Peripheral neuropathy misc Selective dorsal rhizotomy |
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ddc 610 bkl 44.90 bkl 44.67 misc Cerebral palsy misc Electron microscope misc Peripheral neuropathy misc Selective dorsal rhizotomy |
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Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy |
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Fukuhara, Toru Nakatsu, Daisuke Namba, Yoichiro Yamadori, Ichiro |
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histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy |
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Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy |
| abstract |
Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. This finding should be reminded as a precaution when considering nonselective dorsal rhizotomy, especially, for children who are expected to stand up after the surgery. |
| abstractGer |
Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. This finding should be reminded as a precaution when considering nonselective dorsal rhizotomy, especially, for children who are expected to stand up after the surgery. |
| abstract_unstemmed |
Purpose It has been advocated that intraoperative electrophysiological monitoring is mandatory in selective dorsal rhizotomy (SDR). However, it is still uncertain whether the monitoring procedure effectively differentiates dysfunctional rootlets. We histologically analyzed sectioned rootlets in SDR, in order to confirm the efficacy of the monitoring. Methods Seven children with cerebral palsy underwent SDR on the same protocol. The pieces of their sectioned nerve rootlets from L5 were examined histologically using an electron microscope. In each patient, two nerve rootlets, one with the most abnormal response to intraoperative electrical stimulation and the other with the least abnormal response, were examined. The electron microscope findings of the rootlets were compared with the electromyography (EMG) findings in the intraoperative stimulation. Results Among 14 examined nerve rootlets, definite abnormal EMG findings were seen in 5, which were 4 clonuses and one bilateral spread. All five rootlets with abnormal EMG findings showed axonal degenerations except one case, whose finding was dysmyelination. On the contrary, in the nine rootlets with normal EMG findings, eight rootlets had histologically minimum changes limited to the myelin sheath and one rootlet had dysmyelination without axonal degeneration. Conclusions The nerve rootlets with abnormal EMG findings in the intraoperative stimulation have definite histological abnormalities. This indicates that intraoperative monitoring is a meaningful method for identifying the nerve rootlets to be sectioned. This finding should be reminded as a precaution when considering nonselective dorsal rhizotomy, especially, for children who are expected to stand up after the surgery. |
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| title_short |
Histological evidence of intraoperative monitoring efficacy in selective dorsal rhizotomy |
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https://dx.doi.org/10.1007/s00381-011-1462-5 |
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Nakatsu, Daisuke Namba, Yoichiro Yamadori, Ichiro |
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Nakatsu, Daisuke Namba, Yoichiro Yamadori, Ichiro |
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10.1007/s00381-011-1462-5 |
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2024-07-04T01:47:36.122Z |
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| score |
7.399884 |