Ann Rehabil Med.  2020 Oct;44(5):353-361. 10.5535/arm.19164.

Association Between Latency of Dermatomal Sensory-Evoked Potentials and Quantitative Radiologic Findings of Narrowing in Lumbar Spinal Stenosis

• Yang DC
• Lee HJ
• Park JW
• Nam K
• Kim S
• Cho KT
• Kwon BS

• KMID: 2508460
• DOI: http://doi.org/10.5535/arm.19164

Abstract

Objective
To identify the difference of quantitative radiologic stenosis between a normal latency group and an abnormal latency group, and to investigate the association of dermatomal somatosensory-evoked potential (DSEP) with magnetic resonance imaging (MRI) findings of narrowing in patients with lumbar spinal stenosis (LSS).
Methods
We retrospectively reviewed the clinical records and P40 latencies of L5 DSEP of 40 patients with unilateral symptoms of LSS at the L4–5 disc level. Quantitative assessments of stenosis in lumbar spine MRI were performed with measurements of the anteroposterior diameter (APD), cross-sectional area (CSA) of the dural sac, ligamentous interfacet distance (LID), CSA of the neural foramen (CSA-NF), and subarticular zone width. Analyses were conducted through comparisons of radiologic severity between the normal and abnormal latency groups and correlation between radiologic severity of stenosis and latency of DSEP in absolute (APD <10 mm) and relative (APD <13 mm) stenosis.
Results
The radiologic severities of lumbar stenosis were not significantly different between the normal and abnormal latency groups. In absolute and relative stenosis, latency showed a significant negative correlation with APD (r=-0.539, r=-0.426) and LID (r=-0.459, r=-0.494). In patients with relative stenosis, a weak significant positive correlation was found between latency and CSA-NF (r=0.371, p=0.048). LID was the only significant factor for latency (β=-0.930, p=0.011).
Conclusion
The normal and abnormal DSEP groups showed no significant differences inradiologic severity. The latency of DSEP had a negative correlation with the severity of central stenosis, and LID was an influencing factor.

Keyword

Evoked potentials; Magnetic resonance imaging; Spinal stenosis; Electrodiagnosis

Figure

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  Fig. 1. (A) The white arrow indicates the ligamentous interfacet distance measured between the inner surfaces of ligamentum flavum by connecting the joint space of facet joints. (B) Cross-sectional area of the dural sac is indicated by the white hatched area. (C) The black arrow indicates the anteroposterior diameter of the osseous spinal canal. (D) The minimal width of the subarticular zone was measured at the level of nerve roots using the disc, ligamentum flavum or facet joint as structures that constitute the borders of the neural canal. (E) The cross-sectional area of the neural foramen was measured on sagittal images below the pedicle. Because the nerve root is located more cranially than the lower end plate, no space below the line parallel to the lower end plate was included in area measurements.

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