Intraoperative electrical stimulation of the human dorsal spinal cord reveals a map of arm and hand muscle responses.

"participants were adult patients with cervical spondylotic myelopathy multilevel foraminal stenosis or intradural tumor requiring surgical treatment ( table 1 supplemental table s1; all supplemental material is available at https://doi org/10 6084/m9 figshare 19891966 ).; the data that support the findings of this study are available from the corresponding authors upon reasonable request 10 6084/m9 figshare 19891966 supplemental materials: https://doi org/10 6084/m9 figshare 19891966 ."

"DISCLOSURES J. B. Carmel is a founder and stockholder in BackStop Neural and a scientific advisor for SharperSense. M. S. Virk has been a consultant and has received honorarium from Depuy Synthes, Nuvasive, and BrainLab Inc; he is on the Medical Advisory Board and owns stock with OnPoint Surgical. N. Y. Harel is a consultant for RubiconMD. K. D. Riew: consulting: Happe Spine (nonfinancial), Nuvasive; royalties: Biomet; speaking and/or teaching arrangements: Biomet, Medtronic (travel expense reimbursement); stock ownership: Amedica, Axiomed, Benvenue, Expanding Orthopedics, Osprey, Paradigm Spine, Spinal Kinetics, Spineology, Vertiflex. R. A. Lehman: consulting: Medtronic; royalties: Medtronic, Stryker. Z. M. Sardar: consulting: Medtronic; grant/research support from the Department of Defense. J. M. Lombardi: consulting: Medtronic, Stryker. None of the other authors has any conflicts of interest, financial or otherwise, to disclose."

"HHS | NIH | National Institute of Neurological Disorders and Stroke (NINDS)10.13039/100000065; HHS | NIH | National Institute of Neurological Disorders and Stroke (NINDS)10.13039/100000065; HHS | NIH | National Institute of Neurological Disorders and Stroke (NINDS)10.13039/100000065; Travis Roy Foundation (TRF)10.13039/100003330"

"Participants were adult patients with cervical spondylotic myelopathy, multilevel foraminal stenosis, or intradural tumor requiring surgical treatment (, Supplemental Table S1; all Supplemental Material is available at https://doi.org/10.6084/m9.figshare.19891966). Patients were enrolled from the clinical practices of the spine surgeons participating in the study. The study protocol was reviewed and approved by the Institutional Review Boards of the two study sites, Weill Cornell Medical Center and Columbia University Irving Medical Center (ClinicalTrials.gov number: NCT05163639; participants were recruited after registration). Patients with stimulation devices in the neck or chest (e.g., vagal nerve stimulation, cardiac patients with pacemakers) or head and neck implants were excluded. Written informed consent for participation in the study was obtained before surgery for every participant. Participants underwent standard of care preoperative clinical assessments. Clinical MRI scans were used to determine T2 signal hyperintensity within the spinal cord and also the degree of foraminal stenosis. We defined severe foraminal stenosis as no detectable cerebrospinal fluid within the foramen. Modified Japanese Orthopaedic Association (mJOA) scores were used to assess the severity of myelopathy. These experiments were powered with effect size based on comparisons of midline and lateral stimulation in the rat (). Conservatively assuming a reduced effect size by 50% compared with the rat experiments (Cohen’s d = 0.97 vs. 1.94), the analysis indicated that to achieve 90% power with a Wilcoxon signed-rank test (α = 0.05) would require 14 participants. Additional participants were recruited to map responses from each cervical segment, with a minimum of five participants from each level of the cervical enlargement (C5–T1)."