Gluteal contraction with lumbar motor testing

[schmee90]

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What are peoples thoughts on gluteal contractions with motor testing with L5DR. Maybe this is too nuanced a question, but I am a relatively new graduate and has former attending who thought it was acceptable and other who did not. I haven't found any real direction in the literature on this.

I have talked to former attending, one who did not think it was acceptbale as you were activating the suprior gluteal nerve, another attending who thought it was acceptable as you were only activlting lumbar paraspinals in that area and was only concerned if motor testing at L5 DR was below the buttocks.

Would love to hear any additional insights as always

 

[callmeanesthesia]

If pulling back a little doesn’t resolve it and there’s nothing going down the leg, I burn anyway. I’ve only run into it a few times but haven’t encountered any complications from it.

 

[paindoc503]

I also occasionally encounter motor and sensory stim into the upper gluteal area with DR5. As long as it does radiate down the leg further, I’ve always went ahead with the burn. I’m hesitant to pull back off of os, because I seem to lose the motor response altogether.