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Results of intraoperative neurophysiological monitoring in spinal canal surgery
- Gumed Klinika Neurochirurgii, Smoluchowskiego
- Kliniczny Oddział Anestezjologii i Intensywnej Terapii, 4 Wojskowy Szpital Kliniczny we Wrocławiu
- Katedra Neurologii i Neurochirurgii, Klinika Neurochirurgii Uniwersytetu Warmińsko-Mazurskiego w Olsztynie
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Abstract
Spine surgery carries the risk of neurological complications. Neurophysiological intraoperative monitoring (NIOM) plays some role in preventing adverse events. NIOM is a young technique, and because of its costs and additional personnel it requires constant evaluation of indications. Nowadays, it is generally assumed that if available, NIOM should be used in every intracanal surgical procedure. This study aimed to evaluate the efficacy and indications for NIOM in spine surgery in relation to procedure location.
Material and methodsEffectiveness of NIOM in spinal canal surgery was evaluated by comparison of the number of neurological complications in patients treated surgically with and without NIOM. A total of 74 consecutive patients were surgically treated for spinal canal pathology at the Department of Neurosurgery, 10th Military Hospital in Bydgoszcz. Thirty-eight patients operated on with the use of NIOM were compared to a historic population of 36 patients treated before the introduction of NIOM. The number of patients with neurological complications was analyzed in three groups based on surgical location: extradural, intradural extramedullary, and intramedullary procedures. Differences between groups were tested with the Fisher exact test.
ResultsThe number of neurological complications was significantly lower in the intramedullary procedure group with NIOM. There was no significant difference in the number of complications in patients undergoing intra- or extradural extramedullary procedures with versus without NIOM.
ConclusionsNIOM decreases the risk of neurological complications in spinal cord surgery, but not in extramedullary spinal canal procedures.
Abstract
Spine surgery carries the risk of neurological complications. Neurophysiological intraoperative monitoring (NIOM) plays some role in preventing adverse events. NIOM is a young technique, and because of its costs and additional personnel it requires constant evaluation of indications. Nowadays, it is generally assumed that if available, NIOM should be used in every intracanal surgical procedure. This study aimed to evaluate the efficacy and indications for NIOM in spine surgery in relation to procedure location.
Material and methodsEffectiveness of NIOM in spinal canal surgery was evaluated by comparison of the number of neurological complications in patients treated surgically with and without NIOM. A total of 74 consecutive patients were surgically treated for spinal canal pathology at the Department of Neurosurgery, 10th Military Hospital in Bydgoszcz. Thirty-eight patients operated on with the use of NIOM were compared to a historic population of 36 patients treated before the introduction of NIOM. The number of patients with neurological complications was analyzed in three groups based on surgical location: extradural, intradural extramedullary, and intramedullary procedures. Differences between groups were tested with the Fisher exact test.
ResultsThe number of neurological complications was significantly lower in the intramedullary procedure group with NIOM. There was no significant difference in the number of complications in patients undergoing intra- or extradural extramedullary procedures with versus without NIOM.
ConclusionsNIOM decreases the risk of neurological complications in spinal cord surgery, but not in extramedullary spinal canal procedures.
Keywords
neurophysiological monitoring, spine surgery, spinal cord tumors
Title
Results of intraoperative neurophysiological monitoring in spinal canal surgery
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
27-31
Page views
246
Article views/downloads
308
DOI
10.5114/ninp.2013.32937
Bibliographic record
Neurol Neurochir Pol 2013;47(1):27-31.
Keywords
neurophysiological monitoring
spine surgery
spinal cord tumors
Authors
Piotr Zieliński
Rafał Gendek
Dariusz Paczkowski
Marek Harat
Krzysztof Dzięgiel
Paweł Sokal