Potentiels évoqués somesthésiques au cours des interventions orthopédiques sur le rachis de l'adulte

Lille, F; Petit, B; Margules, S; Mazel, Christian; Roy-Camille, R

doi:10.1016/s0987-7053(05)80229-1

Cited by 8 publications

(1 citation statement)

References 18 publications

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“…For example, as little as 0.8°C of hypothermia increases latency [28]. This can be caused by a deeper level of anaesthesia [4, 10,32,33,44] or by haemodynamic disturbances such as hypotension, tachycardia or bradycardia, and also by local vascular abnormalities such as arterial occlusions or spasms, or external compression of vessels by a haematoma, bone graft, screw or bone or disk fragment [15,19,30]. It could be argued that we are testing the function of the posterior cord (sensory pathway) and not the more important and interesting anterior motor pathway.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative control by somatosensory evoked potentials in the treatment of cervical myeloradiculopathy. Results in 210 cases

Sebastian¹,

Raya²,

Ortega³

et al. 1997

Eur Spine J

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Somatosensory evoked potentials (SEPs) were used for continuous monitoring of 210 patients during anterior surgery for cervical myeloradiculopathy, to test how effectively they help avoid irreversible neurological damage during surgery. The pathologies differed in severity and were treated by diskectomy or by extended corporectomy using the Senegas technique. Intraoperative SEP changes were recorded in 84 patients (40%); in 13 (6.2%) of these, changes in SEP amplitude and latency were caused by mechanical stress. SEPs revealed transient episodes of regional ischaemia or neurophysiological anomalies during anaesthesia (mainly hypotension) in 27 patients (12.8%). The traces detected incipient and potentially dangerous mechanical pressure on, or metabolic anomalies of, the spinal cord during manipulation and placement procedures of spinal fixation devices. They were particularly sensitive indicators of ischaemia; one of the most common causes of irreversible injury. The traces of 44 patients (21.0%) improved markedly during surgery. There were no falsenegatives in this series and, thanks to the fact that SEPs gave immediate warnings of incipient ischaemia to the surgical team, we had no case of irreversible medullary or nerve-root deficit.

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