EVALUATION OF INTRAOPERATIVE SOMATOSENSORY-EVOKED POTENTIAL MONITORING DURING 100 CERVICAL OPERATIONS

被引：110

作者：

EPSTEIN, NE ^{[1
]}

DANTO, J ^{[1
]}

NARDI, D ^{[1
]}

机构：

[1] N SHORE UNIV HOSP,CORNELL MED CTR,DEPT SURG,DIV NEUROSURG,MANHASSET,NY 11030

来源：

SPINE | 1993年 / 18卷 / 06期

关键词：

Cervical surgery; Somatosensory evoked potential monitoring;

D O I：

10.1097/00007632-199305000-00011

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Continuous intraoperative somatosensory-evoked potential monitoring during scoliosis surgery, along with improved instrumentation techniques, has contributed to the reduction of neurologic injury from 4-6.9% to 0-0.7%. To assess whether somatosensory-evoked potential monitoring might play a similar role in cervical surgery, the authors compared the morbidity and mortality rates associated with 218 patients who were not monitored and were operated on between 1985-1989 with those found in 100 consecutive somatosensory-evoked potential monitored procedures done from 1989-1991. The cervical procedures were conducted for disc disease, stenosis, spondylosis, and ossification of the posterior longitudinal ligament. Eight of 218 unmonitored patients became quadriplegic (3.7%) and 1 died (0.5%); no instances of quadriplegia and no deaths were encountered among the 100 monitored patients. The reduction of neurologic deficit was attributed in part to early somatosensory-evoked potential detection of vascular or mechanical compromise of the spinal cord or nerve roots and to the immediate alteration of anesthetic or surgical technique in response to somatosensory-evoked potential changes, i,e., reversal of systemic or ''relative'' hypotension, adjustment of operative position, release of distraction, and cessation of manipulation. Continuous intraoperative somatosensory-evoked potential monitoring also was a practical tool in monitoring cervical surgery.

引用

页码：737 / 747

页数：11

共 25 条

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