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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.12
- 수록면
- 831 - 839 (9page)
- DOI
- 10.31616/asj.2021.0078
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초록· 키워드
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Study Design: Retrospective case series.
Purpose: To evaluate the risks and causes of neurologic complications in three-column spinal surgery by analyzing intraoperative neurophysiological monitoring (IONM) data.
Overview of Literature: Three-column spinal surgery, which may be required to correct complex spinal deformities or resection of spinal tumors, is known to carry a high risk of neurologic complications. However, few studies reported a specific surgical procedure related to a significant IONM signal change during surgery.
Methods: Multimodality IONM data, including somatosensory-evoked potentials (SSEP) and motor-evoked potentials (MEP), were reviewed in 64 patients who underwent three-column spinal surgery from 2011 to 2015. Surgical procedures included posterior ver tebral column resection, pedicle subtraction osteotomy, total en bloc spondylectomy, piecemeal spondylectomy, and corpectomy with laminectomy (n=27) in three cervical, 34 thoracic, and 31 lumbar procedures.
Results: Significant IONM signal changes occurred in 11 of 64 (17.1%) patients. SSEP and MEP were changed in 11 patients. Postop erative neurologic deterioration occurred in 54.5% (6 of 11) of the patients, and two of them were permanent. There was no postoper ative neurologic deterioration in patients without significant signal change. Suspected causes of IONM data changes are as follows: adhesion/tethering, translation, contusion, and perfusion.
Conclusions: Based on the results of this study, to enhance neurologic safety in three-column spinal surgery, surgeons should pay attention to protect the spinal cord from mechanical insult, especially when the spinal column was totally destabilized during surgery, and not to compromise perfusion to the spinal cord in close cooperation with a neurologist and anesthesiologist.
목차
등록된 정보가 없습니다.
참고문헌 (28)
참고문헌 신청
Cristante L / 1994 / Surgical management of intramedullary spinal cord tumors : functional outcome and sources of morbidity / Neurosurgery 35:69~74
Bridwell KH / 1998 / Major intraoperative neurologic deficits in pediatric and adult spinal deformity patients : incidence and etiology at one institution / Spine(Phila Pa 1976) 23:324~331
Bilsky MH / 2000 / Single-stage posterolateral transpedicle approach for spondylectomy, epidural decompression, and circumferential fusion of spinal metastases / Spine(Phila Pa 1976) 25:2240~2249
Wang JC / 2004 / Single-stage posterolateral transpedicular approach for resection of epidural metastatic spine tumors involving the vertebral body with circumferential reconstruction : results in 140 patients : invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004 / J Neurosurg Spine 1:287~298
Constantini S / 2000 / Radical excision of intramedullary spinal cord tumors: surgical morbidity and longterm follow-up evaluation in 164 children and young adults / J Neurosurg 93(2 Suppl):183~193
Bridwell KH / 1998 / Major intraoperative neurologic deficits in pediatric and adult spinal deformity patients : incidence and etiology at one institution / Spine(Phila Pa 1976) 23:324~331
Bilsky MH / 2000 / Single-stage posterolateral transpedicle approach for spondylectomy, epidural decompression, and circumferential fusion of spinal metastases / Spine(Phila Pa 1976) 25:2240~2249
Wang JC / 2004 / Single-stage posterolateral transpedicular approach for resection of epidural metastatic spine tumors involving the vertebral body with circumferential reconstruction : results in 140 patients : invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004 / J Neurosurg Spine 1:287~298
Constantini S / 2000 / Radical excision of intramedullary spinal cord tumors: surgical morbidity and longterm follow-up evaluation in 164 children and young adults / J Neurosurg 93(2 Suppl):183~193
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