NEUROPHYSIOLOGICAL AND URODYNAMIC EXAMINATIONS IN THE FUNCTIONAL ASSESSMENT OF THE SPINAL-CORD BELOW THE INJURY SITE

We examined the characteristics of specific components of the evoked e lectrospinogram (EESG) in response to tibial nerve stimulation in 28 p atients with traumatic injury of the dorsal and cervical spinal cord. The data were correlated with clinical, urodynamic and additional neur ophysiological findings. In the majority of patients (82%), 11 with co mplete and 12 with partial spinal cord lesions, the lumbar components of the EESG were normal. In 4 of these patients with complete lesion a bove T2 the dorsal EESG was absent. In 5 cases (18%), the lumbosacral EESG was altered in the presence of an atypical clinical syndrome char acterized by persistent urinary retention associated with lower leg at rophy and reduced tendon jerks. In these cases, MRI provided evidence of an unexpected sacral lesion. Unlike the dorsal EESG reflecting the afferent dorsal column volley, the lumbar components of the EESG are u sually unaffected by interruption of the cord pathways; these last eve nts thus originate from segmental neuronal activity, the involvement o f which bears witness to additional lumbosacral damage.