Hideki Shigematsu1, Tomoshige Miyabayashi2, Sachiko Kawasaki3, Yuma Suga3, Yasuhito Tanaka3. 1. Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, 6348522, Japan. shideki@naramed-u.ac.jp. 2. Division of Central Clinical Laboratory, Nara Medical University, Nara, Japan. 3. Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, 6348522, Japan.
Abstract
PURPOSE: Transcranial electrical stimulation motor-evoked potentials (TES-MEPs) are an intraoperative neurophysiologic monitoring method that reduces adverse outcomes in various spine surgeries. Although spine surgeons rarely use TES-MEPs for simple lumbar decompression surgery, we herein firstly report the efficacy of TES-MEPs for lumbar spinal canal stenosis with asymptomatic coexisting cervical canal stenosis. METHODS: We report the case of a 71-year-old man who underwent lumbar decompression surgery for lumbar spinal canal stenosis. He had asymptomatic cervical spinal canal stenosis before surgery. RESULTS: TES-MEPs showed apparent derivation failure of wave amplitudes from the upper and lower limb muscles immediately after posture change from supine to prone for operative preparation. The cervical alignment was corrected. Subsequently, the TES-MEP wave amplitudes became derivable immediately. CONCLUSIONS: While TES-MEPs can be used to prevent neurological deficits in lumbar spine surgery, it can also be used to indirectly monitor other spinal lesions. Based on our experience, we recommend using TES-MEPs even in lumbar spine surgery.
PURPOSE: Transcranial electrical stimulation motor-evoked potentials (TES-MEPs) are an intraoperative neurophysiologic monitoring method that reduces adverse outcomes in various spine surgeries. Although spine surgeons rarely use TES-MEPs for simple lumbar decompression surgery, we herein firstly report the efficacy of TES-MEPs for lumbar spinal canal stenosis with asymptomatic coexisting cervical canal stenosis. METHODS: We report the case of a 71-year-old man who underwent lumbar decompression surgery for lumbar spinal canal stenosis. He had asymptomatic cervical spinal canal stenosis before surgery. RESULTS: TES-MEPs showed apparent derivation failure of wave amplitudes from the upper and lower limb muscles immediately after posture change from supine to prone for operative preparation. The cervical alignment was corrected. Subsequently, the TES-MEP wave amplitudes became derivable immediately. CONCLUSIONS: While TES-MEPs can be used to prevent neurological deficits in lumbar spine surgery, it can also be used to indirectly monitor other spinal lesions. Based on our experience, we recommend using TES-MEPs even in lumbar spine surgery.
Authors: John E Ziewacz; Sigurd H Berven; Valli P Mummaneni; Tsung-Hsi Tu; Olaolu C Akinbo; Russ Lyon; Praveen V Mummaneni Journal: Neurosurg Focus Date: 2012-11 Impact factor: 4.047
Authors: Michael G Vitale; David L Skaggs; Gregory I Pace; Margaret L Wright; Hiroko Matsumoto; Richard C E Anderson; Douglas L Brockmeyer; John P Dormans; John B Emans; Mark A Erickson; John M Flynn; Michael P Glotzbecker; Kamal N Ibrahim; Stephen J Lewis; Scott J Luhmann; Anil Mendiratta; B Stephens Richards; James O Sanders; Suken A Shah; John T Smith; Kit M Song; Paul D Sponseller; Daniel J Sucato; David P Roye; Lawrence G Lenke Journal: Spine Deform Date: 2014-08-27