Author(s): Bieber E, Tolo V, Uematsu S
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Abstract Two hundred seventy-five consecutive patients who were treated by posterior spinal instrumentation and fusion with iliac crest bone graft were intraoperatively monitored using cortical somatosensory-evoked potentials without a planned wake-up test. The monitoring was performed using a TECA TE-4 system that included an electromyograph, a nerve stimulator, and a digital averager. Intraoperatively, six patients (2\%) demonstrated significant changes in evoked potentials, consisting of either marked increase in latency or a loss of wave form during instrumentation of the spine. The instrumentation was removed immediately and the evoked potentials returned to base-line tracing within 15-30 minutes in all six cases. Five patients who had instruments refitted to maintain a lesser amount of correction had no subsequent change in the evoked potentials. One patient had spinal fusion without instrumentation. Postoperatively, all patients are neurologically normal.
This article was published in Clin Orthop Relat Res
and referenced in Journal of Spine