Mapping dermatomes during selective dorsal rhizotomy: Case report and review of the literature

Andrew N. Nemecek*, Anthony M. Avellino, Robert Goodkin, James Little, Michel Kliot

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Studies suggest that the pattern of dermatomal segmental innervation in any given patient, may differ from the classic dermatomal maps first described in the 1890s. Such variability may limit the effectiveness of selective dorsal rhizotomy for treatment of neurogenic pain. Case Description: A 46-year-old male presented with a 27-year history of intractable pain in his left arm after being shot during the Vietnam War; multiple surgical and medical therapeutic modalities failed to produce durable pain relief. The patient underwent selective dorsal rhizotomy, with intraoperative dermatomal and mixed somatosensory evoked potential recordings. Pre- and postrhizotomy recordings were compared, effectively mapping this patient's dermatomal pattern. At 4 years' follow-up, the patient remains pain free. Conclusion: Intraoperative monitoring of somatosensory evoked potentials during dorsal rhizotomy for neurogenic pain can be used to establish the degree to which an individual's pattern of segmental innervation conforms to the traditionally described dermatomes.

Original languageEnglish (US)
Pages (from-to)292-297
Number of pages6
JournalSurgical Neurology
Volume60
Issue number4
DOIs
StatePublished - Oct 1 2003

Keywords

  • Dermatome
  • Monitoring
  • Rhizotomy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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