Iatrogenic @entity1566 is the most feared complication of @entity1635 surgery. The importance of combined somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) monitoring during spine surgery is well known. The current authors retrospectively evaluated the results of neurophysiological intraoperative monitoring (IOM) in a large population of @entity1 who underwent surgical treatment for @entity85 . Intraoperative monitoring of SEPs and transcranial electrical stimulation MEPs (TES-MEP) was performed in 172 successive @entity1 who underwent surgical treatment of idiopathic (128 pts), congenital (15 pts) or syndromic (29 pts) @entity1635 . The first 106 @entity1 (Group 1) underwent only SEP monitoring, while the other 66 @entity1 (Group 2) underwent combined SEP and TES-MEP monitoring, when the technique was introduced in the current authors' institution. Halogenate anaesthesia ( @entity2614 , MAC 0.6-1.2) was performed in Group 1 cases, total intravenous anaesthesia ( @entity1875 infusion, 6-10 mg/kg/h) in Group 2 @entity1 . A neurophysiological "alert" was defined as a reduction in amplitude (unilateral or bilateral) of at least 50% for SEPs and of 65% for TES-MEPs compared with baseline. In Group 1, two @entity1 (1.9%) developed postoperative @entity51 following surgical correction of @entity85 , consisting of permanent @entity1746 in one case and transient @entity1746 secondary to spinal cord ischaemia in the other. Twelve @entity1 presented intraoperative significant changes of neurophysiological parameters that improved following corrective actions by surgeons and anaesthesiologists, and did not show any postoperative @entity51 . In ten cases the alert was apparently unrelated to surgical manoeuvres or to pharmacological interventions and no postoperative @entity51 were noted. Considering the @entity1 of Group 2, two @entity1 (3.0%) presented transient postoperative @entity51 preceded by significant intraoperative changes in SEPs and TES-MEPs. In five cases a transient reduction in the amplitudes of SEPs (1 @entity1 ) and/or TES-MEPs (5 @entity1 ) was recorded intraoperatively with no postoperative @entity51 . In conclusion, in the current series of 172 @entity1 the overall prevalence of postoperative neurologic deficit was 2.3% (4 @entity1 ). When combined SEP and TES-MEP monitoring was performed, the sensitivity and specificity of IOM for @entity3481 was 100 and 98%, respectively. Combined SEP and TES-MEP monitoring must be regarded as the neurophysiological standard for intraoperative detection of emerging @entity1566 during corrective @entity85 surgery. Early detection affords the surgical team an opportunity to perform rapid intervention to prevent @entity130 or possibly to reverse impending neurologic sequelae.

The prevention of neural complications in the surgical treatment of XXXX : the role of the neurophysiological intraoperative monitoring.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1635 :: ('MESH:D012600', 'Disease') :: ['scoliosis'] @entity1746 :: ('MESH:D020335', 'Disease') :: ['paraparesis'] @entity3481 :: ('MESH:D015417', 'Disease') :: ['sensory-motor impairment'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurologic deficits'] @entity1875 :: ('MESH:D015742', 'Chemical') :: ['Propofol'] @entity2614 :: ('MESH:C009250', 'Chemical') :: ['Sevoflurane'] @entity1566 :: ('MESH:D013119', 'Disease') :: ['spinal cord injury'] @entity85 :: ('MESH:D009140', 'Disease') :: ['spinal deformity'] @entity130 :: ('MESH:D014947', 'Disease') :: ['injury progression']
@entity1635 :: (MESH:D012600,Disease) :: ['scoliosis']
