Correlation of the intra-operative neuromonitoring data and emg-characteristics of post-operative motor deficit in patients with spinal deformities

Шеин, А. П.; Sayphutdinov, М S; Скрипников, А. А.; Криворучко, Г. А.; Ryabykh, S. O.

doi:10.17116/hirurgia2017419-23

Cited by 4 publications

(2 citation statements)

References 6 publications

(5 reference statements)

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“…However, in the absence of clinical signs of neurological disorders, instrumental research methods make it possible to identify more pronounced deviations of EMG parameters in the patients who have undergone negative intraoperative events, than in those after a smooth course of surgery. [ 11 , 12 ]. This condition has been defined as subclinical sensorimotor deficit [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors interpret these alterations as false positive responses of the pyramidal tract of the spinal cord [ 9 ], however, there is no unanimous opinion on this issue [ 7 , 10 ]. The results of our studies have shown that even in the absence of postoperative neurological deficit, adverse intraoperative events accompanied by negative changes in the MEP lead to a decrease in neurophysiological sensorimotor parameters [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative Neurophysiological Monitoring during Surgical Correction of Scoliosis for Postoperative Recovery of the Patient’s Motor Function

Arestova¹,

Сайфутдинов²,

Savin³

et al. 2021

Sovrem Tehnol Med

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The aim of the investigation was to study the effect of adverse intraoperative events on the subclinical decrease in the functional state of the sensorimotor system of patients with scoliosis and their early postoperative rehabilitation. Materials and Methods The results of the examination of 30 adolescents of 13–16 years old with scoliosis before and after surgical correction were compared. Intraoperative neurophysiological monitoring was used by the method of transcranial evoked motor potentials. The patients were divided into two groups depending on the presence or absence of neurophysiological signs of damage to nerve structures during the operation. Results The amplitude of the M-responses of the muscles of the lower limbs in the postoperative period remains at a level close to the initial one, with a noticeable decrease in the amplitude of voluntary electromyography, which is expressed unevenly and to a greater extent in patients with intraoperative signs of hazard for the motor pathways of the spinal cord. Conclusion Adverse intraoperative events cause significant changes in the state of the motor system of patients with scoliosis and reduce the effectiveness of rehabilitation treatment in the postoperative period.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intraoperative Neurophysiological Monitoring during Surgical Correction of Scoliosis for Postoperative Recovery of the Patient’s Motor Function

Arestova¹,

Сайфутдинов²,

Savin³

et al. 2021

Sovrem Tehnol Med

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Intraoperative response of the pyramidal system to surgical correction of spinal deformities of various etiologies

et al. 2019

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Objective. To assess the information value of comparing the results of formalizing intraoperative changes in transcranial motor evoked potentials during surgical correction of spinal deformities of various etiologies. Material and Methods. Study design: analysis of monocentric retrospective unselected cohort over 5 years, evidence class 2b. Surgical correction of spinal deformity under neurophysiological control was performed in 364 patients (mean age 12.80 ± 0.40 years). The scores of changes in motor evoked potentials were used to compare the pyramidal system response to surgical aggression in patients with congenital spinal deformities, idiopathic scoliosis, and systemic skeletal diseases. Results. Basic motor responses in patients with systemic diseases of the axial skeleton are to a greater extent depressed and unstable than in those with congenital deformity and idiopathic scoliosis. On surgery completion, these differences are exacerbated. Five identified types of response of the spinal cord conduction pathways to surgical correction of spinal deformity allow comparing intraoperative neuromonitoring results in different groups of patients. The most dangerous types of response are observed more often in patients with congenital and systemic pathologies than in those with idiopathic scoliosis. Conclusion. The proposed method for the rank assessment of intraoperative changes in motor evoked potentials during surgical correction of spinal deformity allows comparative studies of patients' reactions to surgical intervention in different etiological and age groups. The greatest risk of iatrogenic motor disorders in the postoperative period is observed in patients with systemic skeletal pathology. Цель исследования. Оценка информативности сравнения результатов формализации интраоперационных изменений транскраниально вызванных моторных потенциалов при хирургической коррекции деформации позвоночника разной этиологии. Материал и методы. Дизайн исследования: анализ ретроспективной моноцентровой сплошной когорты за 5 лет, класс доказательности 2b. Хирургическая коррекция деформации позвоночника под нейрофизиологическим контролем проведена 364 пациентам (средний возраст 12,80 ± 0,40 года). По результатам балльной оценки изменений моторных вызванных потенциалов сравнивали реакцию пирамидной системы на хирургическую агрессию у пациентов с врожденными деформациями позвоночника, идиопатическим сколиозом и системными заболеваниями скелета. Результаты. У пациентов с системными заболеваниями осевого скелета базовые моторные ответы в большей степени, чем при врожденной деформации и идиопатическом сколиозе, угнетены и нестабильны. После окончания операции эти различия усугубляются. Выделенные 5 типов реакции проводящих путей спинного мозга на хирургическую коррекцию деформации позвоночника позволяют сравнивать результаты интраоперационного нейромониторинга у разных групп больных. При врожденной и системной патологии наиболее опасные типы реакции наблюдаются чаще, чем при коррекции идиопатических сколиозов. Заключение. Предложенн...

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Results of simultaneous and staged surgical techniques for the correction of congenital spine deformities associated with intracanal anomalies in children

et al. 2020

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Correlation of the intra-operative neuromonitoring data and emg-characteristics of post-operative motor deficit in patients with spinal deformities

Cited by 4 publications

References 6 publications

Intraoperative Neurophysiological Monitoring during Surgical Correction of Scoliosis for Postoperative Recovery of the Patient’s Motor Function

Intraoperative Neurophysiological Monitoring during Surgical Correction of Scoliosis for Postoperative Recovery of the Patient’s Motor Function

Intraoperative response of the pyramidal system to surgical correction of spinal deformities of various etiologies

Results of simultaneous and staged surgical techniques for the correction of congenital spine deformities associated with intracanal anomalies in children

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