Positioning-Related Neuromonitoring Change During Anterior

World Neurosurg · Sep 2018

Case Reports

Positioning-Related Neuromonitoring Change During Anterior Cervical Discectomy and Fusion.

Intraoperative neuromonitoring (ION) signal changes during spine surgery may portend a potentially catastrophic neurologic injury that, if identified and addressed expediently, may allow the surgeon to take correction actively and prevent permanent neurologic injury. ⋯ The use of multimodality ION is recommended for ACDF with shoulder traction to prevent postoperative neurologic deficit associated with a position-related injury. Baseline ION should be established before positioning.

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- Hiroyuki Yoshihara, Robert Pivec, and Adel Naam.
- Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA. Electronic address: hiroyoshihara55@yahoo.co.jp.
- World Neurosurg. 2018 Sep 1; 117: 238-241.
BackgroundIntraoperative neuromonitoring (ION) signal changes during spine surgery may portend a potentially catastrophic neurologic injury that, if identified and addressed expediently, may allow the surgeon to take correction actively and prevent permanent neurologic injury.Case DescriptionWe report a case of transient loss in somatosensory evoked potentials signals during anterior cervical discectomy and fusion (ACDF) C4-7, which was mainly attributed to shoulder traction using a special device. The signal loss returned immediately after the release of should traction.ConclusionsThe use of multimodality ION is recommended for ACDF with shoulder traction to prevent postoperative neurologic deficit associated with a position-related injury. Baseline ION should be established before positioning.Copyright © 2018 Elsevier Inc. All rights reserved.

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Positioning-Related Neuromonitoring Change During Anterior Cervical Discectomy and Fusion.

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