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- Publisher Website: 10.1016/j.wneu.2018.04.162
- Scopus: eid_2-s2.0-85047276363
- PMID: 29729461
- WOS: WOS:000436519600093
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Article: High-Risk Surgical Maneuvers for Impending True-Positive Intraoperative Neurologic Monitoring Alerts: Experience in 3139 Consecutive Spine Surgeries
Title | High-Risk Surgical Maneuvers for Impending True-Positive Intraoperative Neurologic Monitoring Alerts: Experience in 3139 Consecutive Spine Surgeries |
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Authors | |
Keywords | High-risk maneuvers Intraoperative neurologic monitoring (IONM) Spine surgery True-positive IONM alerts |
Issue Date | 2018 |
Publisher | Elsevier 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? |
Abstract | BACKGROUND:
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 Identifier | http://hdl.handle.net/10722/259424 |
ISSN | 2023 Impact Factor: 1.9 2023 SCImago Journal Rankings: 0.654 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wang, S | - |
dc.contributor.author | Yang, Y | - |
dc.contributor.author | Li, Q | - |
dc.contributor.author | Zhu, J | - |
dc.contributor.author | Shen, J | - |
dc.contributor.author | Tian, Y | - |
dc.contributor.author | Hu, Y | - |
dc.contributor.author | Li, Z | - |
dc.contributor.author | Xu, W | - |
dc.contributor.author | Jiao, Y | - |
dc.contributor.author | Cao, R | - |
dc.contributor.author | Zhang, J | - |
dc.date.accessioned | 2018-09-03T04:07:12Z | - |
dc.date.available | 2018-09-03T04:07:12Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | World Neurosurgery, 2018, v. 115, p. e738-e747 | - |
dc.identifier.issn | 1878-8750 | - |
dc.identifier.uri | http://hdl.handle.net/10722/259424 | - |
dc.description.abstract | BACKGROUND: 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.language | eng | - |
dc.publisher | Elsevier Inc. The Journal's web site is located at http://www.worldneurosurgery.org/ | - |
dc.relation.ispartof | World Neurosurgery | - |
dc.subject | High-risk maneuvers | - |
dc.subject | Intraoperative neurologic monitoring (IONM) | - |
dc.subject | Spine surgery | - |
dc.subject | True-positive IONM alerts | - |
dc.title | High-Risk Surgical Maneuvers for Impending True-Positive Intraoperative Neurologic Monitoring Alerts: Experience in 3139 Consecutive Spine Surgeries | - |
dc.type | Article | - |
dc.identifier.email | Hu, Y: yhud@hku.hk | - |
dc.identifier.authority | Hu, Y=rp00432 | - |
dc.identifier.doi | 10.1016/j.wneu.2018.04.162 | - |
dc.identifier.pmid | 29729461 | - |
dc.identifier.scopus | eid_2-s2.0-85047276363 | - |
dc.identifier.hkuros | 289699 | - |
dc.identifier.volume | 115 | - |
dc.identifier.spage | e738 | - |
dc.identifier.epage | e747 | - |
dc.identifier.isi | WOS:000436519600093 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1878-8750 | - |