• Qing Yue, Tyson Hale, Aaron Knecht, and Jennifer Laidacker.
• Department of Neurology, Geisinger Medical Center, Danville, Pennsylvania, USA; Department of Audiology and Speech Pathology, Bloomsburg University of Pennsylvania, Bloomsburg, Pennsylvania, USA. Electronic address: qyue@bloomu.edu.
• World Neurosurg. 2017 Jan 1; 97: 755.e1-755.e3.

BackgroundFootdrop secondary to L5 root injury is a rare complication associated with lumbar surgery. It is unclear whether intraoperative neuromonitoring can detect such an injury.Case DescriptionA 54-year-old man who had had bilateral chronic L5 radiculopathy underwent L4-S1 lumbosacral decompression and fusion. During surgery, the patient lost transcranial electrical motor evoked potentials (tceMEPs) from the left tibialis anterior (TA) at the time of L5-S1 intervertebral cage placement. Neither intraoperative free-run electromyography nor somatosensory evoked potentials detected any changes. In addition, contralateral TA tceMEPs remained stable. Postoperatively, the patient presented with left-sided footdrop that has persisted for >1 year.ConclusionsIntraoperative TA tceMEPs could detect L5 root iatrogenic injury.Copyright © 2016 Elsevier Inc. All rights reserved.

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