Neurophysiological Studies in Cervical Stenosis

  • Vincenzo Denaro


In the investigation of cervical stenosis, neurological assessment must always be regarded as fundamental. The types of tests that are routinely performed include electromyography (EMG) nerve conduction velocity (NCV) tests, and sensory and motor evoked potential studies. The purpose of these is to evaluate the extent of the myeloradicular compromise, define the type of neuropathological process, help establish the differential diagnosis, predict the probable results of surgery, and monitor the status of medullary function in both surgical and nonoperative treatment. EMG studies are usually undertaken first, as part of any extensive and complete laboratory assessment but only somatostensory evoked potential (SEP) studies can assess cord function.


Motor Unit Median Nerve Ulnar Nerve Spinal Stenosis Cervical Cord 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Anziska B, Cracco RO (1980) Short latency somatosensory evoked potentials: studies in patients with focal neurological disease. Electroencephalogr Clin Neurophysiol 49:227–239PubMedCrossRefGoogle Scholar
  2. Brown RH, Nash CL, Berilla JA, Amaddio MD (1984) Cortical evoked potential monitoring. A system for intraoper-ative monitoring of spinal cord function. Spine 9: 256–261PubMedCrossRefGoogle Scholar
  3. Cusick JF, Myklebust J, Larson SJ, Sances A Jr (1978) Spinal evoked potentials in the primate: neural substrates. J Neurosurg 49:551–557PubMedCrossRefGoogle Scholar
  4. D’Alpa F, Russo P, Bonfiglio G, Pero G, Grasso A (1985) Assessment of spinal cord function in cervical myelopathies by spinal stenosis or herniated disc. Acta Neurol (Napoli)40:394–398Google Scholar
  5. D’Alpa F (1984) An analysis of spinal (median nerve) SEPs components in healthy subjects. Acta Neurol (Napoli) 39; 413–417Google Scholar
  6. D’Alpa F (1985) Comparison of cervical SEPs on median, radial and ulnar nerve stimulation. Ital J Neurol Sci 6:177–183PubMedCrossRefGoogle Scholar
  7. D’Alpa F, Sallemi G, Triffiletti L, Grasso A (1986) A Cervical SEPs from radicular (digital) upper limb nerves stimulation. Acta Neurol (Napoli) 41: 602–609Google Scholar
  8. Desmedt JE, Cheron G (1980) Central somatosensory conduction in man: neural generators and interpeak latencies of the far-field components recorded from neck and right or left scalp and earlobes. Electoencephalogr Clin Neurophysiol 50:382–403CrossRefGoogle Scholar
  9. Desmedt JF, Cheron G (1981) Paravertebral (oesophageal) recording of subcortical somatosensory evoked potential in man: the spinal PI3 component and the dual nature of the spinal generators. Electroencephalogr Clin Neurophysiol 52:257–275PubMedCrossRefGoogle Scholar
  10. Dinner DS, Lueders H, Lesser RP, et al. (1986) Intraoperative spinal somatosensory evoked potential monitoring. J Neurosurg 65:807–814PubMedCrossRefGoogle Scholar
  11. Drechsler F (1985) Short latency SEP to median nerve stimulation: recording methods, origin of components and clinical application. Electromyogr Clin Neurophysiol 25:115–134PubMedGoogle Scholar
  12. Eisen A, Ellfker G (1980) Sensory nerve stimulation and evoked cerebral potentials. Neurology (NY) 30: 1097– 1105Google Scholar
  13. El Negamy E, Sedgwick NJ (1978) Delayed cervical somatosensory potentials in cervical spondylosis. J Neurol Neurosurg Psychiatry 42: 238–241CrossRefGoogle Scholar
  14. Ganes T (1980) Somatosensory conduction times and peripheral, cervical and cortical evoked potentials in patients with cervical spondylosis. J Neurol Neurosurg Psychiatry 43:683–689PubMedCrossRefGoogle Scholar
  15. Grundy BL (1982) Monitoring of sensory evoked potentials during neurosurgical operations: methods and applications. Neurosurgery 11: 556–575PubMedCrossRefGoogle Scholar
  16. Hattori S, Saiki K, Kawai S (1979) Diagnosis of the level and severity of cord lesion in cervical spondylotic myelopathy. Spinal evoked potentials. Spine 4: 478–485PubMedCrossRefGoogle Scholar
  17. Ioku M (1984) Hand H-reflex demonstrated in patient with central nervous system disorders. Electromyogr Clin Neurophysiol 24:331–339PubMedGoogle Scholar
  18. Ioku M, Otsu T, Akizuki S (1988) Hand H-reflex and short latency somatosensory evoked potentials (SSEPs): clinical evaluation in patients with cervical cord lesions. Electromyogr Clin Neurophysiol 28: 295–300PubMedGoogle Scholar
  19. Jorg J, Dullberg W, Koeppen S (1982) Diagnostic value of segmental somatosensory evoked potentials in cases with chronic progressive para or tetra spastic syndrome. Adv Neurol 12Google Scholar
  20. Kubota S, Nagashima C, Ohmori S (1988) Segmental spinal somatosensory evoked potentials in cervical myelopathies due to spondylosis, ossification of the posterior longitudinal ligament and developmental cervical stenosis. Neu-rorthopedics 5:25–35Google Scholar
  21. La Joie WJ, Melvin JL (1983) Somatosensory evoked potentials elicited from individual cervical dermatomes represented by different fingers. Electromyogr Clin Neurophysiol 23: 403–411PubMedGoogle Scholar
  22. Lesser RP, Lueders H, Hahn J, Klem G (1981) Early somatosensory potentials evoked by median nerve stimulation: intraoperative monitoring. Neurology (N4) 31:1519–1523Google Scholar
  23. Louis AA; Gupta P, Perkash I (1985) Localization of sensory levels in traumatic quadriplegia by segmental somatosensory evoked potentials. Electroencephalogr Clin Neurophysiol 62:313–316PubMedCrossRefGoogle Scholar
  24. Marsden CD, Merton PA, Morton HB (1982) Percutaneous stimulation of spinal cord and brain: pyramidal tract conduction velocities in man. J Physiol (Lond) 328:6PGoogle Scholar
  25. Merton PA, Morton HB, Hill DK, Marsden CD (1982) Scope of a technique for electrical stimulation of human brain, spinal cord and muscle. Lancet 2:597–600PubMedCrossRefGoogle Scholar
  26. Mills KR, Murray NMF (1986) Electrical stimulation of the human vertebral column: which neural elements are excited? Electroencephalogr Clin Neurophysiol 63:582–589PubMedCrossRefGoogle Scholar
  27. Rossini PM, di Stefano F, Stanzione P (1985) Nerve impulse propagation along central and peripheral fast conducting motor and sensory pathways in man. Electroencephalogr Clin Neurophysiol 60: 320–334PubMedCrossRefGoogle Scholar
  28. Siivola J, Sulg I, Heiskari M (1981) Somatosensory evoked potentials in diagnostics of cervical spondylosis and herniated disc. Electroencephalogr Clin Neurophysiol 52:276– 282PubMedCrossRefGoogle Scholar
  29. Stohr M, Buettner UW, Riffel B (1982) Spinal somatosensory evoked potentials in cervical cord lesions. Electroencephalogr Clin Neurophysiol 54: 257–265PubMedCrossRefGoogle Scholar
  30. Yamada T, Kimura J, Nitz DM (1980) Short latency somatosensory evoked potentials following median nerve stimulation in man. Electroencephalogr Clin Neurophysiol 48:367–376PubMedCrossRefGoogle Scholar
  31. Yu YL, Leong CY, Fang D, Woo E, Huang CY, Lau HK (1988) Cervical myelopathy due to ossification of the posterior longitudinal ligament. Brain 111: 769–783PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • Vincenzo Denaro
    • 1
  1. 1.Catania University, ItalyCataniaItaly

Personalised recommendations