The role of intraoperative somatosensory evoked potentials in the investigation of traction injury of the brachial plexus

A precise anatomical and functional evaluation of root lesions, either intraforaminal or extraforaminal, intraoperatively has been a big challenge to the surgeons. Preoperative clinical examination, electromyographic examinations, cervical myelography with or without CT scan and intraoperative observation with microscope, as well as simple nerve stimulation have been routinely performed to evaluate the root lesions, but often were insufficient. Intraoperative somatosensory evoked potentials can give reliable data on intra- and extra-foraminal root evaluation. It was performed when indicated, but not routinely. Ten patients, 30 roots (C5, 10; C6, 9 ;C7, 7; C8, 4) were evaluated by intraoperative somatosensory evoked potentials. After two years follow-up, surgical results proved the diagnostic tool effective and reliable. It can support the accuracy of the cervical myelograpy and becomes a part of our diagnosis of brachial plexus injury.