Intraoperative neurophysiological monitoring to prevent new neurological deficits in spinal tumor cases İntraoperatif nöromonitörleme ile spinal tümör cerrahisinde yeni defisit gelişiminin önlenmesi

Aydinlar E. I. , Dikmen P. Y. , Silav G., Berkman M. Z. , ELMACI I. , Özgen S.

Turk Noroloji Dergisi, vol.20, no.2, pp.47-50, 2014 (Journal Indexed in SCI Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 2
  • Publication Date: 2014
  • Doi Number: 10.4274/tnd.93798
  • Title of Journal : Turk Noroloji Dergisi
  • Page Numbers: pp.47-50


Objective: Intraoperative neurophysiological monitoring was carried out in patients with spinal cord tumors. These patients were retrospectively evaluated for new postoperative neurological deficits. Material and Method: A total of 32 spinal tumor cases (8 cervical, 14 thoracic, 10 lumbosacral), 17 male and 15 female, patients between 2-66 years of age (mean 44.1±20) operated in our center were evaluated. All of our cases were monitored with somatosensory evoked potentials (SEP) muscular motor evoked potentials (MEP) and free run electromyography. Spinal MEP (D wave), bulbocavernosus reflex (BCR) and pudendal SEP were obtained in appropriate cases. Results: Five cases presented with temporary new postoperative neurological deficits in the form of strength loss. Neurophysiological recordings of all of these patients showed either temporary or permanent deterioration during surgery. The tumor was removed completely or almost completely in 26, near-completely in 4 and partially in 2 cases and none of our cases had a new permanent deficit. Conclusion: The functional integrity of the lateral and dorsal columns of the spine can be assessed by SEP and muscular MEP recording. Additional information about the neurological tissue is given by spinal MEP, BCR and pudendal SEP in suitable cases. We did not experience any false positive or negative results in our cases and we believe that the combined use of intraoperative spinal and MEP in spinal column located tumors gives reliable information about postoperative neurological outcome.