Direct Stimulation of Neural Placode and Nerve Roots in Open Myelomeningocele: The Efficacy of Neural Tube Reconstruction
| Autor: | Yusuf Izci, Alparslan Kırık, Mehmet Can Ezgu, Soner Yaşar |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Neural Tube
Meningomyelocele medicine.diagnostic_test Nerve root business.industry Electromyography Neural tube Infant Newborn Stimulation General Medicine Spinal cord Neurosurgical Procedures Electrophysiology medicine.anatomical_structure Spinal Cord Anesthesia Pediatrics Perinatology and Child Health medicine Humans Surgery Neurology (clinical) business Direct stimulation Lumbosacral joint |
| Zdroj: | Pediatric neurosurgery. 55(6) |
| ISSN: | 1423-0305 |
| Popis: | Introduction: Intraoperative electrophysiological studies are increasingly used in spinal surgery. However, its use in myelomeningocele (MMC) surgery is still not widespread. The aim of this study was to present our experience in neural placode (NP) and nerve root stimulations in newborns with open MMC. Methods: Eight newborns underwent surgical treatment for thoracolumbar and lumbosacral MMCs. Intraoperative neuromonitoring including free-running electromyography and stimulation of NP, nerve roots, and spinal cord were performed in all cases. Stimulation sites and intensities and distal response’s amplitudes and latencies were recorded. Results: Five patients had thoracolumbar and 3 patients had lumbosacral MMC. Two patients had no movements at the lower extremities while the other had some movements. No response on the lower extremities was obtained in only 1 patient. Responses from the nerve root stimulations were more robust and significant than the placode stimulations. Conclusions: It is clear that the NP and nerve roots originating from the placode are mostly functional and should be preserved during the surgery. Intraoperative neuromonitoring and direct stimulation should be performed during the MMC repair in order to obtain a better neurological outcome. |
| Databáze: | OpenAIRE |
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