Gaston Oscar Camino Willhuber1, Mariana Bendersky2, Carolina Vilte3, Gonzalo Kido4, Matias Pereira Duarte5, Martin Estefan6, Julio Bassani7, Matias Petracchi8, Marcelo Gruenberg9, Carlos Sola10. 1. Hospital Italiano de Buenos Aires. gastonc_willhuber@hotmail.com. 2. III Normal Anatomy Department, School of Medicine, University of Buenos Aires, Paraguay 2155, Buenos Aires, Argentina.. mariana.bendersky@hospitalitaliano.org.ar. 3. Intraoperative Monitoring, Pediatric Neurology Department, Italian Hospital of Buenos Aires, Potosi 4215, Buenos Aires, Argentina.. carolina.vilte@hospitalitaliano.org.ar. 4. Institute of Orthopedics "Carlos E. Ottolenghi," Hospital Italiano de Buenos Aires, Potosí 4215, Buenos Aires, Argentina.. gonzalo.kido@hospitalitaliano.org.ar. 5. Institute of Orthopedics "Carlos E. Ottolenghi," Hospital Italiano de Buenos Aires, Potosí 4215, Buenos Aires, Argentina.. matias.pereira@hospitalitaliano.org.ar. 6. Intraoperative Monitoring, Pediatric Neurology Department, Italian Hospital of Buenos Aires, Potosi 4215, Buenos Aires, Argentina.. drmartinestefan@gmail.com. 7. Institute of Orthopedics "Carlos E. Ottolenghi," Hospital Italiano de Buenos Aires, Potosí 4215, Buenos Aires, Argentina.. julio.bassani@hospitalitaliano.org.ar. 8. Institute of Orthopedics "Carlos E. Ottolenghi," Hospital Italiano de Buenos Aires, Potosí 4215, Buenos Aires, Argentina.. matias.petracchi@hospitalitaliano.org.ar. 9. Institute of Orthopedics "Carlos E. Ottolenghi," Hospital Italiano de Buenos Aires, Potosí 4215, Buenos Aires, Argentina.. marcelo.gruenberg@hospitalitaliano.org.ar. 10. Institute of Orthopedics "Carlos E. Ottolenghi," Hospital Italiano de Buenos Aires, Potosí 4215, Buenos Aires, Argentina.. carlos.sola@hospitalitaliano.org.ar.
Abstract
Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back pain due to advanced degenerative disc disease in elderly patients. Complications of this procedure has been described such as infection, vertebral fracture, cement leakage and nerve injury. Intraoperative neuromonitoring is used to detect the latter. The objective of this study was to assess the usefulness of neuromonitoring during discoplasty to detect new neurological compromise. Methods: 100 consecutive patients were included in this retrospective study, (30 males and 70 females, mean age of 76.3 ± 5.71 years) with mechanical low back pain who underwent percutaneous cement discoplasty. Results: Sensitivity to detect neurological injury was 82% (CI 95% 66-98), specificity was of 99% (CI 95%98-100) with a positive predictive value of 0.95 (CI 95% 85-100) and a negative predictive value of 0.97 (CI 95% 95-99). In 5 patients neurological compromise was not detected by neuromonitoring. Discussion: Our study showed high sensitivity and specificity of neuromonitoring to detect neurological irritation during percutaneous discoplasty. Intraoperative neuromonitoring resulted an effective assistance during this minimally invasive procedure. Universidad Nacional de Córdoba
Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back pain due to advanced degenerative disc disease in elderly patients. Complications of this procedure has been described such as infection, vertebral fracture, cement leakage and nerve injury. Intraoperative neuromonitoring is used to detect the latter. The objective of this study was to assess the usefulness of neuromonitoring during discoplasty to detect new neurological compromise. Methods: 100 consecutive patients were included in this retrospective study, (30 males and 70 females, mean age of 76.3 ± 5.71 years) with mechanical low back pain who underwent percutaneous cement discoplasty. Results: Sensitivity to detect neurological injury was 82% (CI 95% 66-98), specificity was of 99% (CI 95%98-100) with a positive predictive value of 0.95 (CI 95% 85-100) and a negative predictive value of 0.97 (CI 95% 95-99). In 5 patients neurological compromise was not detected by neuromonitoring. Discussion: Our study showed high sensitivity and specificity of neuromonitoring to detect neurological irritation during percutaneous discoplasty. Intraoperative neuromonitoring resulted an effective assistance during this minimally invasive procedure. Universidad Nacional de Córdoba
Authors: Cameron K Schmidt; Tarush Rustagi; Fernando Alonso; Marios Loukas; Jens R Chapman; Rod J Oskouian; R Shane Tubbs Journal: Childs Nerv Syst Date: 2017-06-16 Impact factor: 1.475
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