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Efficacy of Head Repositioning in Restoration of Electrophysiological Signals During Cervical Spine Procedures
- Source :
- Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society. 34(2)
- Publication Year :
- 2016
-
Abstract
- To evaluate the frequency of loss of neurophysiological potentials during head positioning, the usefulness of head repositioning to restore the potentials, and the effect on neurological outcome.We retrospectively reviewed consecutive cervical spine surgeries performed at the Israel Spine Center, Assuta Medical Center, during 2006 to 2013. Surgeries performed with neuromonitoring (transcranial-electric motor evoked potentials, somatosensory evoked potentials, electromyographic recordings) were included. Demographic data, medical history, findings at neurological examination and imaging, electrophysiological data recorded during surgery, and neurological outcomes were collected and analyzed.Three hundred eighty-one patients met inclusion criteria. Loss of potentials detected in nine patients during patient positioning and repositioning was undertaken with the aim of restoring electrophysiological signals. In 5/9 patients, repositioning resulted in immediate reappearance of potentials; in 1/5, potentials were affected again during decompression. In 4/9, repositioning did not immediately restore electrophysiological signals; in ¼, potentials reappeared later during the decompression and in ¾, potentials had not recovered till the conclusion of surgery. There were new neurological deficits in 2/9, including one patient with loss of potential that was not restored with repositioning and the one in whom potential was restored but lost again during decompression.Intraoperative neuro monitoring is an efficient tool to alert the surgical team to potential neurological damage. Head reposition often restores the electrophysiological signals with possible prevention of impending sequelae.
- Subjects :
- Adult
Male
medicine.medical_specialty
Intraoperative Neurophysiological Monitoring
Physiology
Head (linguistics)
Patient Positioning
03 medical and health sciences
0302 clinical medicine
Physiology (medical)
Evoked Potentials, Somatosensory
medicine
Humans
Aged
Retrospective Studies
030222 orthopedics
business.industry
Electromyography
Neurophysiology
Middle Aged
Decompression, Surgical
Cervical spine
Surgery
Electrophysiology
Neurology
Cervical Vertebrae
Female
Neurology (clinical)
business
Head
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15371603
- Volume :
- 34
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
- Accession number :
- edsair.doi.dedup.....9094bb5b88509690ec7ef35fec2eefa9