Martínez AJJ, Muńoz RI, Collado CMÁ, Torres VLG, Obregón CA, Mondragón SM, Chávez GH, de Leo VRA

Language: Spanish
References: 9
Page: 98-104
PDF size: 290.78 Kb.

ABSTRACT

Background: Degenerative disorders of the lumbar spine are a heterogeneous group of pathologies. Intraoperative neurophy- siologic monitoring has been used as an adjuvant tool in spine surgery to reduce the incidence of neural complications and to register the changes with prognostic value of postoperative im- provement. At the same time, we search to reduce the complication incidence of neurological structure lesion, which reflects an improvement in surgical results. Methods: between March 2012 and June 2014, in a prospective series, 112 patients with diagnosis of lumbar spondilosis who were surgically treatedby the same surgen with foramina recalibration, with or without intersomatic cage by posterolateral intersomatic fusion technique, and posterior interspinous fixation with ASPEN under transurgical multimodal neurophysiologic monitoring^®. Results: We found a relationship with Oswestry Disability Index with an average improvement of 11.6%, with a higher amplitude in SSEP (p = 0.046) when the average percentage in latency was 0.7%, and 35.1% of amplitude, which means better values respecting base values. Conclusions: Intraoperative neurophysiological monitoring is an valuable resource used in lumbar spine surgery, which improves procedure safety, and provides a prognostic value regarding postoperative follow-up

REFERENCES

1. Ney JP, van der Goes DN, Nuwer MR. Does intraoperative neurophysiologic monitoring matter in noncomplex spine surgeries? Neurology. 2015; 85 (24): 2151-2158.

2. Kelleher MO, Tan G, Sarjeant R, Fehlings MG. Predictive value of intraoperative neurophysiological monitoring during cervical spine surgery: a prospective analysis of 1,055 consecutive patients. J Neurosurg Spine. 2008; 8 (3): 215-221.

3. Collado MA, de Leo R, Sandoval V, Díaz A, Gutiérrez B, Shkurovich P. Vigilancia neurofisiológica transoperatoria multimodal en cirugía de columna. Cir Ciruj. 2009; 77 (5): 385-390.

4. Fairbank JC, Couper J, Davies JB, O’Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980; 66 (8): 271-273.

5. Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE. Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol. 1995; 96 (1): 6-11.

6. Péréon Y, Nguyen The Tich S, Delécrin J, Pham Dang C, Bodin J, Drouet JC et al. Combined spinal cord monitoring using neurogenic mixed evoked potentials and collision techniques. Spine (Phila Pa 1976). 2002; 27 (14): 1571-1576.

7. Thompson PD, Day BL, Crockard HA, Calder I, Murray NM, Rothwell JC et al. Intra-operative recording of motor tract potentials at the cervico-medullary junction following scalp electrical and magnetic stimulation of the motor cortex. J Neurol Neurosurg Psychiatry. 1991; 54 (7): 618-623.

8. Deletis V, Sala F. Intraoperative neurophysiological monitoring of the spinal cord during spinal cord and spine surgery: a review focus on the corticospinal tracts. Clin Neurophysiol. 2008; 119 (2): 248-264.

9. Gavaret M, Jouve JL, Péréon Y, Accadbled F, André-Obadia N, Azabou E et al. Intraoperative neurophysiologic monitoring in spine surgery. Developments and state of the art in France in 2011. Orthop Traumatol Surg Res. 2013; 99 (6 Suppl): S319-327.