Intraoperative neurophysiological monitoring during spinal surgery
| Autor: | P. Viganò, S. Lollini, G. de Scisciolo, C. Martinelli, S. Caserta, D. Fabris |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
business.industry Kyphosis Scoliosis medicine.disease Sensory Systems Degenerative disc disease Surgery Lumbar Neurology Physiology (medical) medicine Neurology (clinical) Neurosurgery medicine.symptom business Tibial nerve Paresis Intraoperative neurophysiological monitoring |
| Zdroj: | Clinical Neurophysiology. 130:e6-e7 |
| ISSN: | 1388-2457 |
| DOI: | 10.1016/j.clinph.2018.09.053 |
| Popis: | Intraoperative neurophysiological monitoring (IOM) is a technique that may contribute to avoiding permanent neurological injury during spine surgery procedure, especially in patients undergoing scoliosis correction. In the last 12 months 26 patients underwent spinal procedures for scoliosis and kyphosis, spinal (cervical or lumbar) stenosis, degenerative disc disease; a patient with posttraumatic L1 fracture and a patient with intradural extramedullary neurinoma were monitored too. TIVA-TCI anesthesia was used in all patients while muscle relaxants were limited only during some patient’s intubation. SEPs (median and tibial nerve) and MEPs (ADM and TA-AH muscles and in cervical surgery also deltoid and ECD muscles) were attempted in all patients. Spontaneous EMG activity was also recorded from multiple muscles. Only in two cases we had significant prolonged alterations of IOM: during a D3 neurinoma surgery we observed the loss of MEPs from a leg with return at normality after a stop and change of neurosurgery procedures; in a decompression/stabilization D10-S1 cortical SEPs and MEPs of right leg slowly reduced progressively until the end of surgery (with a slight transitory paresis). The use of IOM in spine surgery affects positively the neurological outcome so that it has to become a routine procedure. |
| Databáze: | OpenAIRE |
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