European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2016
Return of motor evoked potentials after knee flexion in the setting of high-grade spondylolisthesis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Tilan Justin, Andras Lindsay M, Krieger Mark D, Skaggs David L
Аннотация
PURPOSE: To present a case of loss of motor-evoked potentials (MEPs) to the left foot in the supine position after a partial reduction and instrumented fusion from L4 to pelvis which was managed successfully without revision or removal of implants.
METHODS: We report a patient with high-grade spondylolisthesis who demonstrated loss of motor-evoked potentials after posterior spinal fusion and transfer to supine position. The patient's knees were flexed to 90° and signals were immediately restored. Systemic steroids were administered and circumferential fusion was delayed 21 days. Anterior-interbody cage was placed without complication.
RESULTS: She was discharged on post-operative day 2. At 7 months, she is pain free and doing well with plans to return to gymnastics completely.
CONCLUSIONS: Knee flexion can be instituted when encountering a neuromonitoring signal change following posterior spinal fusion for spondylolisthesis as a means to alleviate acute nerve stretch injury and may in some cases prevent the need to lessen the correction.
LEVEL OF EVIDENCE: IV.
METHODS: We report a patient with high-grade spondylolisthesis who demonstrated loss of motor-evoked potentials after posterior spinal fusion and transfer to supine position. The patient's knees were flexed to 90° and signals were immediately restored. Systemic steroids were administered and circumferential fusion was delayed 21 days. Anterior-interbody cage was placed without complication.
RESULTS: She was discharged on post-operative day 2. At 7 months, she is pain free and doing well with plans to return to gymnastics completely.
CONCLUSIONS: Knee flexion can be instituted when encountering a neuromonitoring signal change following posterior spinal fusion for spondylolisthesis as a means to alleviate acute nerve stretch injury and may in some cases prevent the need to lessen the correction.
LEVEL OF EVIDENCE: IV.