Intraoperative Nerve Testing

[daveinaustin]

Has anybody heard about Intraoperative Nerve Testing? I read an interesting article on it from a Podiatry source, comparing it to nerve conduction test (NCV):

http://www.podiatrytoday.com/has-int...-nerve-surgery

There's other articles on it as well, and I'm just starting my research. But, I'm pretty darn sure I have a pinched nerve after my last fusion successfully fused that needs to somehow be ablated, decimated, destroyed, whatever!

-Dave

[symara]

i just had the EMG and NCV done yesterday.

SO this article is saying it could show a false negative? I could still have permenant damage regardless of what the test showed?

[daveinaustin]

Excellent question. The way I read it was in the context of the ankle and foot:

... the most common workup for tarsal tunnel and other peripheral nerve problems has been a nerve conduction test (NCV) with or without an electromyelogram (EMG). Both of these tests have shown moderately good potential in the upper extremity but have been very poor in the diagnosis of lower extremity nerve problems.

Honestly, I don't know enough about NCV for the lumbar, and would like to learn more Interoperative Nerve Testing and NCV.

[KBear]

needs to somehow be ablated, decimated, destroyed, whatever!

Sounds like a job for a terminator!

[symara]

Excellent question. The way I read it was in the context of the ankle and foot:

... the most common workup for tarsal tunnel and other peripheral nerve problems has been a nerve conduction test (NCV) with or without an electromyelogram (EMG). Both of these tests have shown moderately good potential in the upper extremity but have been very poor in the diagnosis of lower extremity nerve problems.

Honestly, I don't know enough about NCV for the lumbar, and would like to learn more Interoperative Nerve Testing and NCV.

When they tested my nerves it was tested through my legs and feet. They didn't do anything to my lower back untl they did the muscle test.

[Justin]

Hey Dave,

I think the background on nerve injury would be helpful in explaining why they would do intraoperative nerve testing. The article below from Wikipedia is actually really good and explains the 3 types of nerve injury: neurapraxia, axonotmesis and neurotmesis. It also has links to associated terms such as Wallerian degeneration, which would be helpful to understand the "big picture" nerve injury.

• Wikipedia Article on Nerve Injury

Here's a link to Trauma Rehabilitation by Lawerence Russell Robinson (2005) through Google Books (there is a nice chart on nerve injury that includes both the Seddon and Sunderland Classifications): Click here.

Here's three great resources of Seddon's Classification of Nerve Injury that was published in 1943 and expanded upon by Sunderland in 1978:

• CNS NeuroWiki Classification of Nerve Injury ***This is a great, concise overview of nerve injury.
  
• Emedicine Publication on Acute Nerve Injury
  
• Emedicine Publication on Peripheral Nerve Injury

[daveinaustin]

Thank you Justin. I'll read them tonight!

I'm about to have some coffee, and to get my SCS leads pulled. I still have a couple of days on vacation. It'll be interesting to see how much the SCS trial helped my back vs. good ole fashion Rest and Relaxation. Regardless, I was able to drop my Norco from 6 to 2.5 yesterday!

-Dave

[Justin]

Thank you Justin. I'll read them tonight!

I'm about to have some coffee, and to get my SCS leads pulled. I still have a couple of days on vacation. It'll be interesting to see how much the SCS trial helped my back vs. good ole fashion Rest and Relaxation. Regardless, I was able to drop my Norco from 6 to 2.5 yesterday!

-Dave

Great news Dave! Rest up buddy and enjoy the rest of your vacation (if you can).

[daveinaustin]

Not meaning to complain, but being off the SCS unit is pretty tough. I'm back to 6 Norcos a day with a consistent Level 5-6 pain on the meds.

Although I would really like to determine the root cause of this pain (I'm pretty sure it's sympathetic), at least I have a fall-back plan.

I re-reviewed my MRI CD, and could have a few leads. Hopefully, I'll be able to contact the radiologist to review them again.

-Dave

[KBear]

Not meaning to complain,

That's what we are here for. I know I feel like a whiny butt around friends/family; to the point that I don't let on how much I hurt. On here, I know I can let it out and you all get it and don't think I'm a 'debbie downer'