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Current conventional neurophysiological mapping techniques are not able to differentiate between crucial motor nerve roots and sensory roots. Enhanced differentiation could contribute to complete resection. We present our experience with a double-train paradigm to differentiate between motor and sensory roots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In children undergoing spinal cord lipoma resection, the double-train mapping paradigm was used with an inter-train interval of 60\u00a0ms. Given the longer recovery time due to the H-reflex, a single muscle response was presumed to be elicited from a sensory root, and a double muscle response from a motor root. The primary endpoint was postoperative neurological outcome and bladder function at discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 8 children undergoing 10 lipoma resections between 2016 and 2023. Double-train mapping was used in all cases. Motor and sensory roots were clearly differentiated in 6 cases and altered the course of surgery in 4 cases.<\/jats:p>\n                    <jats:p>Post-surgery, no sensory and motor function worsened within 3\u00a0months. Bladder function was stable in six and improved in two children. In two patients, bladder function worsened slightly at 3\u00a0months and 6\u00a0months, at which point one patient was re-operated on for re-tethering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intraoperative mapping with the double-train paradigm reliably differentiated between motor and sensory nerve roots. Informing the surgeon on the specific function of a tethering root may help to maximize resection without risking major neurological deficits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-024-06673-5","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T03:06:11Z","timestamp":1733454371000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Neurophysiological identification and differentiation between the motor and sensory roots in pediatric spinal cord lipoma surgery"],"prefix":"10.1007","volume":"41","author":[{"given":"Katharina","family":"Lutz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Grunt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cordula","family":"Scherer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin U.","family":"Schuhmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen","family":"Zeino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Vulcu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsany","family":"Hakim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Wermelinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Abel Alvarez","family":"Abut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Pospieszny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Raabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Schucht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Seidel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,6]]},"reference":[{"key":"6673_CR1","doi-asserted-by":"publisher","first-page":"279","DOI":"10.3340\/jkns.2020.0024","volume":"63","author":"D Pang","year":"2020","unstructured":"Pang D (2020) Surgical management of complex spinal cord lipomas\u202f: a new perspective. 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