Format

Send to

Choose Destination
Clin Neurol Neurosurg. 2016 Apr;143:9-14. doi: 10.1016/j.clineuro.2016.02.007. Epub 2016 Feb 9.

Significance of multimodal intraoperative monitoring for the posterior cervical spine surgery.

Author information

1
Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Republic of Korea.
2
Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea, Suwon, Republic of Korea.
3
Department of Neurosurgery, St. Vincent Hospital, The Catholic University of Korea, Suwon, Republic of Korea. Electronic address: jatagi15@paran.com.

Abstract

OBJECTIVE:

The aim of this study was to evaluate the efficacy of multimodal neurophysiologic intra-operative monitoring (IOM) in a cohort of patients who underwent posterior cervical surgery.

MATERIAL AND METHODS:

A total 182 patients were included in this study. Multi-modal intraoperative monitoring (MIOM, somatosensory-evoked potentials: SSEP/transcranial motor-evoked potentials: TCe-MEP/spontaneous-electromyography: S-EMG) was performed in a consecutive series of 129 patients and the other 53 patients (control group) did not. We classified all patients into a high-cervical (H-C) operation group or a low-cervical (L-C) operation group, based on the level of the surgery and analyzed respectively.

RESULTS:

One hundred-eleven cases (86%) showed true negative results. Fourteen patients (9 cases- H-C operation, 5 cases- L-C operation) met the criteria of neurophysiologic changes during operation. Of these, 10 cases were restored to normal during operation spontaneously (7 cases) or with surgical manipulation (all 3 cases were related to H-C operation). All unrestored neurophysiologic cases (n=4) showed new post-operative neurological deficits. Four patients showed neurological deficits without any changes in MIOM (false negative, 3 cases--delayed onset C5 palsy, 1 case--C8 palsy).

CONCLUSIONS:

Proper application of MIOM may be useful to detect intraoperative neurological injury during the posterior cervical operations and improve surgical outcomes especially in subgroup of H-C operation. However, the efficacy of MIOM may be restricted to detect and prevent the delayed onset C5 palsy.

KEYWORDS:

High cervical operation; Low cervical operation; Multi-modal intraoperative monitoring; Posterior cervical spine surgery

PMID:
26878291
DOI:
10.1016/j.clineuro.2016.02.007
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center