Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
SOMATOSENSORY-EVOKED POTENTIAL MONITORING DURING POSITIONING OF THE PATIENT FOR POSTERIOR-FOSSA SURGERY IN THE SEMISITTING POSITION
Autore:
DEINSBERGER W; CHRISTOPHIS P; JODICKE A; HEESEN M; BOKER DK;
Indirizzi:
UNIV GIESSEN,NEUROSURG CLIN,KLIN STR 29 D-35385 GIESSEN GERMANY UNIV GIESSEN,DEPT ANESTHESIOL D-35385 GIESSEN GERMANY
Titolo Testata:
Neurosurgery
fascicolo: 1, volume: 43, anno: 1998,
pagine: 36 - 40
SICI:
0148-396X(1998)43:1<36:SPMDPO>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
MIDCERVICAL FLEXION MYELOPATHY; SITTING POSITION; SPINAL-CORD; OPERATIONS; ISOFLURANE;
Keywords:
MYELOPATHY; PERIOPERATIVE MONITORING; POSTERIOR FOSSA SURGERY; SITTING POSITION; SOMATOSENSORY EVOKED POTENTIALS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
18
Recensione:
Indirizzi per estratti:
Citazione:
W. Deinsberger et al., "SOMATOSENSORY-EVOKED POTENTIAL MONITORING DURING POSITIONING OF THE PATIENT FOR POSTERIOR-FOSSA SURGERY IN THE SEMISITTING POSITION", Neurosurgery, 43(1), 1998, pp. 36-40

Abstract

OBJECTIVE: Midcervical flexion myelopathy is a rare but well-known complication of posterior fossa surgery. To reduce the risk, we routinely used somatosensory evoked potential (SSEP) monitoring during positioning of the patient. METHODS: Fifty-five consecutive patients were operated on for posterior fossa lesions in the semisitting position via amedian (5 patients) or a lateral (50 patients) suboccipital approach. During positioning, monitoring of SSEPs by stimulation of the tibial nerve (T-SSEP) as well as by stimulation of the median nerve (M-SSEP) was established. In the case of pronounced SSEP changes, the head was repositioned. Surgery was started after SSEP recordings were unchangedas compared to the baseline investigation. RESULTS: Effective monitoring was possible in all cases. Whereas M-SSEP recordings showed no changes while placing patients in the sitting position, T-SSEP recordingswere altered in 14 cases (25%). In cases using the midline approach, SSEP changes were never so pronounced to require repositioning of the head. Head flexion and rotation resulted in significant changes of T-SSEP recordings in eight patients (14.5 %), requiring repositioning. Intwo cases, an amplitude loss was noted. In only two of these eight patients were M-SSEP recordings markedly changed. SSEP recordings after repositioning disclosed recovery of spinal cord function. In no patient were clinical signs of myelopathy observed postoperatively. CONCLUSION: We observed a high incidence of pronounced changes of T-SSEP recordings when the patient's head was flexed and rotated for lateral suboccipital craniotomy in the semisitting position. Despite the low specificity monitoring of T-SSEPs during positioning of the patient for posterior fossa surgery, the semisitting position is strongly recommended.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 18:13:38