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J Neurol Surg A Cent Eur Neurosurg 2017; 78(05): 419-430
DOI: 10.1055/s-0036-1593958
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Acute Improvement in Intraoperative EMG Following Common Fibular Nerve Decompression in Patients with Symptomatic Diabetic Sensorimotor Peripheral Neuropathy: 1. EMG Results

James C. Anderson
1   Anderson Podiatry Center for Nerve Pain, Fort Collins, Colorado, United States
,
D. Scott Nickerson
2   Northeast Wyoming Wound Care Center, Sheridan, Wyoming, United States
,
Brian L. Tracy
3   Health and Exercise Science, Colorado State University, Fort Collins, Colorado, United States
,
Roger J. Paxton
3   Health and Exercise Science, Colorado State University, Fort Collins, Colorado, United States
,
Dwayne S. Yamasaki
4   Medtronic Vascular Inc. New Therapy Development, Jacksonville, Florida, United States
› Author Affiliations
Further Information

Publication History

11 April 2016

09 August 2016

Publication Date:
30 December 2016 (online)

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Abstract

Background and Study Aims Electromyographic (EMG) recordings of the fibularis longus (FL) and tibialis anterior (TA) muscles were performed intraoperatively during common fibular nerve (CFN) nerve decompression (ND) in patients with symptomatic diabetic sensorimotor peripheral neuropathy (DSPN) and clinical nerve compression.

Materials and Methods Forty-six legs in 40 patients underwent surgical ND by external neurolysis; FL and TA muscles were monitored intraoperatively. Evoked EMGs were recorded just prior to and within 1 minute after ND.

Results Thirty-eight legs (82.6%) demonstrated EMG improvement 1 minute after ND. Sixty muscles (31 FL, 29 TA) were monitored, with 44 (73.3%) improving in EMG amplitude. Mean change in EMG amplitude represented a 73.6% improvement (p < 0.0001). Changes in EMG amplitudes correlated with visual analog scale pain improvement (p = 0.03).

Conclusion This is the first report of acute changes in objective EMG responses during ND of CFN in DSPN patients and demonstrates that patients with symptomatic DSPN and clinical nerve entrapment have latent but functional axons that surgical ND can improve immediately.

Keywords

common fibular nerve decompression - intraoperative electromyography - motor evoked potentials - acute objective functional improvement

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


Funding

No funding was received for this research.


 

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