Efficacy of Anal Needle Electrodes for Intraoperative Spinal Cord Monitoring with Transcranial Muscle Action Potentials

Autor: Kazuyoshi Kobayashi, Kei Ando, Hideki Yagi, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Yukihiro Matsuyama, Naoki Ishiguro, Shiro Imagama
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Asian Spine Journal, Vol 12, Iss 4, Pp 662-668 (2018)
Druh dokumentu: article
ISSN: 1976-1902
1976-7846
DOI: 10.31616/asj.2018.12.4.662
Popis: Study Design Retrospective study. Purpose To examine the relationship between postoperative bowel bladder disorder (BBD) and the efficacy of needle electrodes for the external anal sphincter (EAS) in intraoperative spinal cord monitoring with transcranial muscle action potentials (Tc-MsEP). Overview of Literature Spinal surgery for spina bifida, spinal cord tumor, and spinal tethered cord syndrome has a high rate of postoperative BBD. Monitoring of the EAS with Tc-MsEP is frequently performed during spinal surgery. We initially used plug-surface electrodes for this purpose, but have more recently switched to needle electrodes for the monitoring of the EAS. To date, there has been no comparison between the utility of these electrodes. Methods Waveform derivation, exacerbation of postoperative BBD, and sensitivity and specificity for prediction of BBD by 70% amplitude reduction of EAS activity using needle and plug-surface electrodes were investigated in 239 spine surgeries. The cut-off for the % drop in amplitude for BBD prediction was determined for EAS monitoring using a needle electrode. Results The overall rate of postoperative BBD aggravation was 7.1% (17/239 cases), with the individual rates using needle and plug-surface electrodes being 6.9% (8/116) and 7.3% (9/123), respectively. The waveform derivation rate was significantly higher using needle electrodes (91.3% [106/116] vs. 76.4% [94/123], p
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