Add like
Add dislike
Add to saved papers

Neurophysiological monitoring of spinal cord function during instrumented anterior cervical fusion.

BACKGROUND CONTEXT: Somatosensory evoked potentials (SSEPs) monitor global spinal cord function, and the interpretation of motor loss is based on inferred rather than direct measurements. Therefore, SSEPs may not be useful for identifying motor function deficits caused by anterior spinal column injury or nerve root injury during decompression or placement of instrumentation. For these reasons, adjunctive methods for monitoring may be especially useful during cervical spine surgery.

PURPOSE: To evaluate the effectiveness of SSEP and transcranial electrical motor evoked potential (tceMEP) monitoring of spinal cord function during anterior fusion of the cervical spine.

STUDY DESIGN/SETTING: Retrospective review.

PATIENT SAMPLE: Consecutive instrumented, anterior cervical spine surgeries performed by the same surgeon at a single institution for 119 patients.

OUTCOME MEASURES: Record of neurophysiological alerts during surgery and record of postoperative neurological deficits not present before surgery.

METHODS: Spinal cord function was monitored intraoperatively with recordings of ulnar and posterior tibial nerve SSEPs and tceMEPs.

RESULTS: Six neurophysiologic alerts occurred that prompted surgeon and/or anesthesiologist intervention. Three patients developed new motor weakness after surgery. One patient had temporary right-leg weakness that was predicted accurately by the disappearance of the right lower extremity tceMEPs. One patient had additional temporary postoperative compromise of the right C5-C6 spinal nerve roots that could not be detected intraoperatively because of absent baseline tceMEPs from the affected muscles. For one patient who developed quadriparesis postoperatively, tceMEP monitoring was precluded by the excessive use of neuromuscular blockade during the procedure.

CONCLUSIONS: The results illustrate the potential utility of intraoperative SSEPs and the tceMEPs for detection of changes in spinal cord function related to patient positioning and hemodynamic effects during anterior cervical fusion.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

Related Resources

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app