Document Detail

Avoiding paraplegia during anterior spinal surgery. The role of somatosensory evoked potential monitoring with temporary occlusion of segmental spinal arteries.
MedLine Citation:
PMID:  1785089     Owner:  NLM     Status:  MEDLINE    
Three patients paraplegic following anterior spinal fusion for congenital kyphoscoliosis were noted to have complete somatosensory evoked potential signal loss shortly after segmental arterial ligations at the apex of their respective kyphosis. This has prompted us to use temporary segmental arterial occlusion with somatosensory evoked potential monitoring prior to ligation during anterior spinal fusion. As a result, we have noted seven additional cases, out of a total of 44 cases monitored in this fashion, in which complete loss of somatosensory evoked potential signals, reversible by release of vascular clips, has occurred. For each of these additional cases the critical segmental arteries were identified and were not ligated, usually resulting in some modifications in the planned surgical procedure, and the patients remained neurologically intact. We recommend temporary segmental arterial occlusion with somatosensory evoked potential monitoring during thoracolumbar anterior spinal fusion to potentially avert ischemic neurologic injury. Based on published data and the experience described herein, this technique should be especially important in anterior spinal fusion for congenital kyphoscoliosis.
D M Apel; G Marrero; J King; V T Tolo; G S Bassett
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  16     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1992-03-17     Completed Date:  1992-03-17     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S365-70     Citation Subset:  IM    
Department of Orthopaedics, Children's Hospital of Los Angeles, California.
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MeSH Terms
Child, Preschool
Evoked Potentials, Somatosensory*
Kyphosis / physiopathology,  surgery*
Ligation / adverse effects
Paraplegia / prevention & control*
Postoperative Complications / prevention & control*
Scoliosis / physiopathology,  surgery*
Spinal Cord / blood supply
Spinal Fusion / methods*
Vertebral Artery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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