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Article: High-Risk Surgical Maneuvers for Impending True-Positive Intraoperative Neurologic Monitoring Alerts: Experience in 3139 Consecutive Spine Surgeries

TitleHigh-Risk Surgical Maneuvers for Impending True-Positive Intraoperative Neurologic Monitoring Alerts: Experience in 3139 Consecutive Spine Surgeries
Authors
KeywordsHigh-risk maneuvers
Intraoperative neurologic monitoring (IONM)
Spine surgery
True-positive IONM alerts
Issue Date2018
PublisherElsevier Inc. The Journal's web site is located at http://www.worldneurosurgery.org/
Citation
World Neurosurgery, 2018, v. 115, p. e738-e747 How to Cite?
AbstractBACKGROUND: Intraoperative neurologic monitoring (IONM) has become an essential component for decreasing the incidence of spinal cord injury during spine surgeries. Many high-risk surgical maneuvers that result in significant IONM alerts have not been reported systematically. Our objective was to thoroughly summarize some common high-risk surgical points associated with IONM alerts in various spine surgeries. METHODS: Between November 2010 and April 2017, 62 patients with true-positive IONM alerts from 3139 spine surgeries were enrolled. Transcranial motor evoked potentials, somatosensory evoked potentials, and free-run electromyography were used for IONM. All 62 patients were identified as true-positive IONM cases. RESULTS: Of 3139 patients, 101 demonstrated significant IONM changes-62 true-positive cases, 14 false-positive cases, and 25 indeterminate IONM results. IONM alerts most often occurred in thoracic screw placement (n = 10, 16.1%), osteotomy (n = 22, 35.5%), correction (n = 19, 30.6%), and spinal cord decompression (n = 11, 17.8%). Appropriate timely measures are indicated in response to IONM alerts during high-risk surgical maneuvers. Ten (10/62, 16.1%) patients showed permanent postoperative neurologic deficits. CONCLUSIONS: IONM alerts are often associated with some specific high-risk surgical maneuvers. Careful and timely observation is crucial.
Persistent Identifierhttp://hdl.handle.net/10722/259424
ISSN
2015 Impact Factor: 2.685
2015 SCImago Journal Rankings: 0.526

 

DC FieldValueLanguage
dc.contributor.authorWang, S-
dc.contributor.authorYang, Y-
dc.contributor.authorLi, Q-
dc.contributor.authorZhu, J-
dc.contributor.authorShen, J-
dc.contributor.authorTian, Y-
dc.contributor.authorHu, Y-
dc.contributor.authorLi, Z-
dc.contributor.authorXu, W-
dc.contributor.authorJiao, Y-
dc.contributor.authorCao, R-
dc.contributor.authorZhang, J-
dc.date.accessioned2018-09-03T04:07:12Z-
dc.date.available2018-09-03T04:07:12Z-
dc.date.issued2018-
dc.identifier.citationWorld Neurosurgery, 2018, v. 115, p. e738-e747-
dc.identifier.issn1878-8750-
dc.identifier.urihttp://hdl.handle.net/10722/259424-
dc.description.abstractBACKGROUND: Intraoperative neurologic monitoring (IONM) has become an essential component for decreasing the incidence of spinal cord injury during spine surgeries. Many high-risk surgical maneuvers that result in significant IONM alerts have not been reported systematically. Our objective was to thoroughly summarize some common high-risk surgical points associated with IONM alerts in various spine surgeries. METHODS: Between November 2010 and April 2017, 62 patients with true-positive IONM alerts from 3139 spine surgeries were enrolled. Transcranial motor evoked potentials, somatosensory evoked potentials, and free-run electromyography were used for IONM. All 62 patients were identified as true-positive IONM cases. RESULTS: Of 3139 patients, 101 demonstrated significant IONM changes-62 true-positive cases, 14 false-positive cases, and 25 indeterminate IONM results. IONM alerts most often occurred in thoracic screw placement (n = 10, 16.1%), osteotomy (n = 22, 35.5%), correction (n = 19, 30.6%), and spinal cord decompression (n = 11, 17.8%). Appropriate timely measures are indicated in response to IONM alerts during high-risk surgical maneuvers. Ten (10/62, 16.1%) patients showed permanent postoperative neurologic deficits. CONCLUSIONS: IONM alerts are often associated with some specific high-risk surgical maneuvers. Careful and timely observation is crucial.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.worldneurosurgery.org/-
dc.relation.ispartofWorld Neurosurgery-
dc.subjectHigh-risk maneuvers-
dc.subjectIntraoperative neurologic monitoring (IONM)-
dc.subjectSpine surgery-
dc.subjectTrue-positive IONM alerts-
dc.titleHigh-Risk Surgical Maneuvers for Impending True-Positive Intraoperative Neurologic Monitoring Alerts: Experience in 3139 Consecutive Spine Surgeries-
dc.typeArticle-
dc.identifier.emailHu, Y: yhud@hku.hk-
dc.identifier.authorityHu, Y=rp00432-
dc.identifier.doi10.1016/j.wneu.2018.04.162-
dc.identifier.pmid29729461-
dc.identifier.hkuros289699-
dc.identifier.volume115-
dc.identifier.spagee738-
dc.identifier.epagee747-
dc.publisher.placeUnited States-

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