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Query: UMLS:C0700208 (scoliosis)
 8,574 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The validity of the somatosensory evoked potential as an intraoperative spinal cord monitor was evaluated in an experimental model of scoliosis in the rat and a Harrington distraction model of injury. Under these conditions, it was found that any change in latency or amplitude of the major negative wave above a certain level was a significant predictor of an adverse neurologic outcome. Changes in latency of 4% or greater and changes in amplitude of 50% or greater were unequivocal indicators of spinal cord injury. Postmortem analyses of the spinal neurotransmitter serotonin revealed that apparent false-positive results of the SEP were, in fact, true-positive results.
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PMID:The somatosensory evoked potential predicts neurologic deficits and serotonergic pathochemistry after spinal distraction injury in experimental scoliosis. 324 92

The relationship of intraoperative monitoring of spinal cord somatosensory evoked potentials and postoperative deficit in 220 cases (121 with scoliosis, 41 with neoplasms, and 58 others) is reported. Bilateral posterior tibial nerve stimulation was used in 181 cases and unilateral median nerve stimulation in 39. Spinal cord (interspinous ligament needles), subcortical (neck surface), and cortical (scalp surface) SEP's were monitored. Seven patients had worsening of neurological function after surgery, three of whom demonstrated significant changes in SEP's monitored. In an additional four cases, there was more than a 50% decrease in amplitude of subcortical/cortical SEP's during monitoring, but no change in neurological status postoperatively. Combined monitoring of spinal cord, subcortical, and cortical SEP's enhanced the certainty of detecting spinal cord dysfunction even though there was a significant number of false-negative and false-positive results. A marked change in the SEP's indicated a high chance of developing a neurological deficit (three or 43% of seven cases), and if there was no change the chance of any neurological postoperative deficit was extremely low (four or 1.87% of 213 cases). These data justify the use of intraoperative SEP monitoring.
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PMID:Intraoperative spinal somatosensory evoked potential monitoring. 377 79

Somatosensory evoked potentials produced by electrical stimulation of the posterior tibial nerve were recorded from surface electrodes at the scalp and cervical spine of a patient with scoliosis undergoing posterior spinal fusion with Cotrel-Dubousset instrumentation. During spinal derotation when hypotension and anemia were also present, the cortical and subcortical somatosensory evoked potentials disappeared. During a wake-up test, the patient demonstrated weakness of the left lower extremity, and derotation was stopped. The patient was given pharmacologic hypertensive agents and blood transfusions to increase blood pressure. Forty minutes later, somatosensory evoked potentials returned and a second wake-up test demonstrated normal function in both lower extremities. This report demonstrates the accuracy and usefulness of somatosensory evoked potential monitoring during spinal fusion with Cotrel-Dubousset instrumentation. To the authors knowledge, this is the first report demonstrating a correlation between abnormal SEP responses and intraoperative neurologic deficit during the derotation maneuver with Cotrel-Dubousset instrumentation and corrected by transfusion and restoration of normotension.
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PMID:Somatosensory evoked potential monitoring during Cotrel-Dubousset instrumentation. Report of a case. 847 15

Controlled arterial hypotension understood to be a mean arterial pressure (MAP) between 55 and 60 mmHg is often used as a complementary technique in anesthesia even though it is not without complications and associated mortality even in young patients. During surgery to reduce scoliosis in a young boy, MAP fell to 60 mmHg accompanied by bilateral loss of sensory and motor evoked potentials (SEP and MEP). Detecting the absence of SEP and MEP allowed us to prevent medullar injury due to ischemia secondary to hypotension, once possible surgical or technical causes had been ruled out. We believe that monitoring SEP and MEP is useful not only to the surgeon but also to the anesthesiologist.
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PMID:[Neurophysiological monitoring during scoliosis surgery using controlled hypotension]. 1110 18