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术中神经监测失败时的三级凹面根尖切除术:遵循检查表使患者术后可步行。

Three-Level Concavity Apical Pediculectomy During Intraoperative Neuromonitoring Loss: Following the Checklist Resulted in an Ambulatory Patient.

作者信息

Butler Danner W, McDonald Tyler C, Suggala Sudhir, Menger Richard

机构信息

Neurosurgery, University of South Alabama, Mobile, USA.

Pediatric Orthopedics, University of South Alabama, Mobile, USA.

出版信息

Cureus. 2024 Jul 17;16(7):e64727. doi: 10.7759/cureus.64727. eCollection 2024 Jul.

Abstract

Adolescent idiopathic scoliosis is the most common form of scoliosis, with severe cases leading to a decline in patients with worsening angulation of deformity. Technical nuances of spinal flexibility and cord type based on the extent of the deformity may impact operating safety and outcome, with risks including neurological loss during and after surgical intervention. Here we present a case of posterior osteotomy and correction of a patient with adolescent idiopathic scoliosis with a T2 - L3 fusion in which transcranial motor evoked potentials (TcMEPs) and somatosensory evoked potentials (SSEPs) were lost intraoperatively, thus requiring application of operative consensus guidelines for the loss of neuromonitoring data. Particularly, the discussion focuses on the decision-making process that resulted in the complete recovery of TcMEPs and SSEPs post-operatively.

摘要

青少年特发性脊柱侧凸是脊柱侧凸最常见的形式,严重病例会导致患者畸形角度恶化。基于畸形程度的脊柱柔韧性和脊髓类型的技术细微差别可能会影响手术安全性和结果,风险包括手术干预期间及之后的神经功能丧失。在此,我们报告一例青少年特发性脊柱侧凸患者行后路截骨术及T2 - L3融合矫正术,术中经颅运动诱发电位(TcMEPs)和体感诱发电位(SSEPs)消失,因此需要应用神经监测数据丢失的手术共识指南。特别地,讨论聚焦于导致术后TcMEPs和SSEPs完全恢复的决策过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da2/11328453/78db35e733df/cureus-0016-00000064727-i01.jpg

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