Hiroyuki Yoshihara1, Robert Pivec2, Adel Naam2. 1. Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA. Electronic address: hiroyoshihara55@yahoo.co.jp. 2. Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA.
Abstract
BACKGROUND: 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. CASE DESCRIPTION: We 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. CONCLUSIONS: 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.
BACKGROUND: 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. CASE DESCRIPTION: We 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. CONCLUSIONS: 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.