Academic Journal
Intraoperative study of afferent and efferent connections in the upper lumbar spinal cord - Part 1: Cremasteric reflex.
| Τίτλος: | Intraoperative study of afferent and efferent connections in the upper lumbar spinal cord - Part 1: Cremasteric reflex. |
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| Συγγραφείς: | de Melo DLM; Department of Clinical Neurophysiology, SARAH Network of Rehabilitation Hospitals, Brasília, DF, Brazil. Electronic address: denisemed@gmail.com., Oliveira DRDCAB; Department of Clinical Neurophysiology, SARAH Network of Rehabilitation Hospitals, Brasília, DF, Brazil., Madureira PLDS; Department of Clinical Neurophysiology, SARAH Network of Rehabilitation Hospitals, Brasília, DF, Brazil., Ventura FD; Department of Clinical Neurophysiology, SARAH Network of Rehabilitation Hospitals, Brasília, DF, Brazil., Dominici M; Department of Clinical Neurophysiology, SARAH Network of Rehabilitation Hospitals, Brasília, DF, Brazil., Pinheiro DS; Department of Clinical Neurophysiology, Federal University of São Paulo, São Paulo, SP, Brazil., Simon MV; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America. |
| Πηγή: | Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2026 Sep; Vol. 189, pp. 2111915. Date of Electronic Publication: 2026 May 07. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 100883319 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8952 (Electronic) Linking ISSN: 13882457 NLM ISO Abbreviation: Clin Neurophysiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Amsterdam : Elsevier, c1999- |
| Ιατρικοί όροι (MeSH): | Reflex*/physiology , Spinal Cord*/physiology , Intraoperative Neurophysiological Monitoring*/methods , Muscle, Skeletal*/physiology , Muscle, Skeletal*/innervation , Efferent Pathways*/physiology , Afferent Pathways*/physiology, Electric Stimulation/methods ; Electromyography/methods ; Humans ; Male ; Adult ; Middle Aged ; Aged ; Lumbar Vertebrae |
| Περίληψη: | Objective: To evaluate the feasibility, neurophysiological characteristics, and stimulation and recording parameters of the cremasteric reflex (CMR) in males under general anesthesia. Methods: Fifteen male patients undergoing spinal surgery with intraoperative neurophysiological monitoring were enrolled. CMR responses triggered using a multipulse train stimulation paradigm were recorded intraoperatively from the cremaster muscle following electrical stimulation of the upper medial thigh. Results: Following ipsilateral upper medial thigh stimulation, CMR responses were recorded in 23 of 30 cremaster muscles across 15 participants, yielding an overall recordability rate of 76%. Mean onset latency was 26.3 ms, and mean peak-to-peak amplitude was 20.0 µV. Recordability was lower in participants with a body mass index greater than 25 kg/m2. Conclusions: CMR responses can be elicited in males under general anesthesia using multipulse train stimulation. Higher BMI appears to negatively affect response recordability. Electrical stimulation frequently induced proximal thigh movement, which may interfere with the surgical field; therefore, recordings should be performed intermittently and only when surgically safe. Significance: This study provides the first demonstration of intraoperative CMR elicitation in humans under general anesthesia. This technique may represent a novel adjunct for monitoring the functional integrity of the upper lumbar spinal cord, L1-L2 nerve roots, and the genitofemoral and ilioinguinal nerves. (Copyright © 2026 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Cremasteric reflex; Genitofemoral nerve; Ilioinguinal nerve; Intraoperative neurophysiological monitoring; Spinal cord reflexes |
| Entry Date(s): | Date Created: 20260511 Date Completed: 20260613 Latest Revision: 20260613 |
| Update Code: | 20260615 |
| DOI: | 10.1016/j.clinph.2026.2111915 |
| PMID: | 42115006 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1872-8952 |
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| DOI: | 10.1016/j.clinph.2026.2111915 |