OBJECTIVE Most of knowledge on muscle radicular innervation was from explorations in root/spinal cord pathologies. Direct and individual access to each of the lumbar-sacral -ventral and dorsal- nerve roots during dorsal rhizotomy for spastic diplegia allows precise study of the corresponding muscle innervation. Authors report the lumbo-sacral segmental myotomal organization obtained from recordings of muscle responses to root stimulation in a 20-children prospective series. METHODS Seven key-muscles in each lower limb and anal sphincter were Electromyography (EMG)-recorded and clinically observed by physiotherapist during L2-to-S2 dorsal rhizotomy. Ventral roots (VR), for topographical mapping, and dorsal roots (DR), for segmental excitability testing, were stimulated, just above threshold for eliciting muscular response. RESULTS In 70% of the muscles studied, VR innervation was pluri-radicular, from 2-to-4 roots, with 1 or 2 roots being dominant at each level. Overlapping was important. Muscle responses to DR stimulation were 1.75 times more extended compared to VR stimulation. Inter-individual variability was important. CONCLUSIONS Accuracy of root identification and stimulation with the used method brings some more precise information to radicular functional anatomy. SIGNIFICANCE Those neurophysiological findings plead for performing Intra-Operative Neuromonitoring when dealing with surgery in the lumbar-sacral roots.

中文翻译：

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痉挛性双瘫腰骶背根切断术对神经根刺激的肌肉反应：对肌节神经支配的洞察

目的 大部分关于肌肉根神经支配的知识来自对根/脊髓病理学的探索。在针对痉挛性双瘫的背根切断术期间，直接和单独进入每个腰-骶-腹侧和背侧-神经根可以精确研究相应的肌肉神经支配。作者报告了从 20 名儿童前瞻性系列中肌肉对根部刺激反应的记录中获得的腰骶节段性肌节组织。方法 物理治疗师在 L2 到 S2 背根切断术期间对每个下肢和肛门括约肌的 7 个关键肌肉进行肌电图 (EMG) 记录和临床观察。用于地形测绘的腹根 (VR) 和用于节段兴奋性测试的背根 (DR) 受到刺激，刚好高于引发肌肉反应的阈值。结果 在所研究的 70% 的肌肉中，VR 神经支配是多根神经支配，从 2 到 4 个根，每个级别有 1 或 2 个根占优势。重叠很重要。与 VR 刺激相比，对 DR 刺激的肌肉反应延长了 1.75 倍。个体间差异很重要。结论所用方法的牙根识别和刺激的准确性为神经根功能解剖学带来了一些更精确的信息。意义这些神经生理学发现要求在处理腰骶根手术时进行术中神经监测。个体间的变异性很重要。结论所用方法的牙根识别和刺激的准确性为神经根功能解剖学带来了一些更精确的信息。意义这些神经生理学发现要求在处理腰骶根手术时进行术中神经监测。个体间的变异性很重要。结论所用方法的牙根识别和刺激的准确性为神经根功能解剖学带来了一些更精确的信息。意义这些神经生理学发现要求在处理腰骶根手术时进行术中神经监测。