Akar Abdulhalim, Sever Gokhan Bulent, Akturk Umut Dogu, Serttas Muhammed Fatih, Ozdemir Ugur, Tekin Omer Faruk, Aydogan Mehmet
Department of Orthopaedics and Traumatology.
Department of Neurosurgery, Emsey Hospital, Istanbul.
J Pediatr Orthop B. 2025 Sep 1;34(5):411-416. doi: 10.1097/BPB.0000000000001206. Epub 2024 Aug 29.
This study aimed to emphasize the effectiveness of using intraoperative neuromonitoring (IONM) in preventing possible nerve damage in Sprengel's deformity surgery. Eighteen patients who underwent Woodward surgery accompanied by neuromonitoring due to Sprengel's deformity were included in the study. Demographic information of the patients and their clinical and cosmetic results before and after surgery were recorded. Complications that occurred during and after the surgery were recorded. Of the 18 patients who underwent surgery, 12 were female and 6 were male. The mean age of the patients was 4.4 (2-8). The mean shoulder abduction angle of the patients was 84.4 (65-105) degrees before the surgery and 151.1 (125-175) degrees in the first year after the surgery. The mean Cavendish score of the patients was 3.6 (3-4) before the surgery and 1.1 (1-2) in the first year after the surgery. In one patient, there was a decrease in IONM motor-evoked potency signals during the reduction of the intraoperative scapula. Considering some loss of correction in the deformity, the scapula was detected at the point where there was no loss of signals. No patients developed wound problems or infections. In this study, it was determined that the use of neuromonitoring was effective in preventing brachial plexus damage, even if this complication was minimal in patients operated on due to Sprengel's deformity.
本研究旨在强调术中神经监测(IONM)在Sprengel畸形手术中预防可能的神经损伤方面的有效性。本研究纳入了18例因Sprengel畸形接受伍德沃德手术并伴有神经监测的患者。记录了患者的人口统计学信息以及他们手术前后的临床和美容效果。记录了手术期间及术后发生的并发症。在接受手术的18例患者中,12例为女性,6例为男性。患者的平均年龄为4.4岁(2 - 8岁)。患者术前平均肩关节外展角度为84.4度(65 - 105度),术后第一年为151.1度(125 - 175度)。患者术前平均卡文迪什评分为3.6(3 - 4),术后第一年为1.1(1 - 2)。在1例患者中,术中肩胛骨复位时IONM运动诱发电位信号降低。考虑到畸形矫正有一定程度的丢失,在信号未丢失的位置检测到肩胛骨。没有患者出现伤口问题或感染。在本研究中,确定神经监测的使用在预防臂丛神经损伤方面是有效的,即使在因Sprengel畸形接受手术的患者中这种并发症极少。