Andres Ramos-Fresnedo1, Gabriella A Rivas2, Oluwaseun O Akinduro1, Alfredo Quiñones-Hinojosa3. 1. Department of Neurosurgery, Mayo Clinic Florida, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA. 2. School of Medicine, Saint George's University, Great River, NY, USA. 3. Department of Neurosurgery, Mayo Clinic Florida, 4500 San Pablo Rd. S, Jacksonville, FL, 32224, USA. quinones@mayo.edu.
Abstract
BACKGROUND: Lumbosacral plexopathies with unclear etiology are a rare entity. In certain cases, if workup unrevealing and medical management is suboptimal, an open lumbar nerve root biopsy may be considered. METHOD: A standard lumbar laminectomy is performed for access to the intradural contents. The dura is opened at midline in a standard fashion. Single nerve roots are selected and stimulated for an EMG response. A nerve fascicle is then dissected and stimulated before excision. CONCLUSION: Lumbar nerve root biopsy is feasible and safe. All non-invasive workup needs to be completed and negative before performing this procedure.
BACKGROUND: Lumbosacral plexopathies with unclear etiology are a rare entity. In certain cases, if workup unrevealing and medical management is suboptimal, an open lumbar nerve root biopsy may be considered. METHOD: A standard lumbar laminectomy is performed for access to the intradural contents. The dura is opened at midline in a standard fashion. Single nerve roots are selected and stimulated for an EMG response. A nerve fascicle is then dissected and stimulated before excision. CONCLUSION: Lumbar nerve root biopsy is feasible and safe. All non-invasive workup needs to be completed and negative before performing this procedure.