BACKGROUND: @entity362 in the lower spinal canal can lead to progressive @entity51 , so they may have to be surgically removed. Intraoperative neurophysiological monitoring serves to minimize the morbidity of the surgical procedure. However, so far there are no evidence-based recommendations which type of monitoring procedure or combination of procedures to choose. METHODS: The aim of this study was to evaluate the feasibility and value of various intraoperative monitoring techniques: motor and sensory evoked potentials (MEP, SEP), free-running and triggered electromyography (EMG). Thirty cases of @entity362 of the Conus medullaris (dorsal Type A: 20.0%; caudal Type B: 33.3%; transitional Type C: 46.7%) were retrospectively evaluated over a 12-year period. RESULTS: The @entity1 were mostly pediatric and suffered from persistent @entity158 (73.3%), pareses (56.7%), @entity51 (60.0%). SEPs were successfully evoked in 66.7% of cases, MEPs in 86.7% of cases, and EMGs in 100%. MEP alterations correlated with direct mechanical maneuvers in the operating site. SEP changes correlated mostly with physiological events, such as rinsing/cooling of the operating site. Spike-, burst- or tonic train-activity was found in the free-running EMG that occurred only with certain manipulation patterns. Irreversible MEP changes and signal loss in the triggered EMG correlated with @entity51 . CONCLUSIONS: The results of this study showed, that intraoperative monitoring could be considered a helpful tool during @entity5 surgery near the Conus medullaris. Most reliable results were obtained from transcranial MEPs, free-running EMGs, and triggered EMGs. That's why the authors favor a routine set-up consisting of at least these three techniques, as this enables mapping at the beginning of the operation, continuous functional testing during surgery, and prognosis of the post-operative symptomology.

The value of intraoperative neurophysiological monitoring for microsurgical XXXX : a 12-year retrospective cohort study.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity362 :: ('MESH:D008067', 'Disease') :: ['spinal lipomas', 'Lipomas'] @entity5 :: ('MESH:D009369', 'Disease') :: ['lipoma tumor'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficits', 'post-operative deficits', 'sensory deficits (43.4%), and/or urogenital dysfunctions'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity362 :: (MESH:D008067,Disease) :: ['removal of conus medullaris lipomas']
