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Hemodynamic Consideration in Intraoperative Neurophysiological Monitoring in Neuromuscular Scoliosis Surgery

Authors
 Seok Young Chung  ;  Chae Hwan Lim  ;  Yoon Ghil Park  ;  Hak Sun Kim  ;  Dawoon Kim  ;  Jinyoung Park 
Citation
 Annals of Rehabilitation Medicine, Vol.46(6) : 292-302, 2022-12 
Journal Title
Annals of Rehabilitation Medicine
ISSN
 2234-0645 
Issue Date
2022-12
Keywords
Blood loss ; Evoked potentials ; Intraoperative neurophysiological monitoring ; Scoliosis
Abstract
Objective: To prove the hypothesis that the parameters of intraoperative neurophysiological monitoring (IONM) during will be more deteriorated in neuromuscular scoliosis (NMS) than in adolescent idiopathic scoliosis (AIS).

Methods: This retrospective study reviewed the data of 69 patients (NMS=32, AIS=37) who underwent scoliosis surgery under IONM. The amplitude of motor evoked potentials (MEPs), and the amplitude and the latency of somatosensory evoked potentials (SEPs) were examined. Demographic, preoperative, perioperative and postoperative data were analyzed to determine whether they affected the IONM parameters for each group.

Results: Of the items analyzed, the bleeding amount was the only significant risk factor for SEP latency deterioration in the NMS group only. The amplitude of SEP and MEP did not correlate with the hemodynamic parameters. The NMS/AIS ratios of the bleeding-related parameters were higher in the order of bleeding amount/weight (2.62, p<0.01), bleeding amount/body mass index (2.13, p<0.01), and bleeding amount (1.56, p<0.01). This study suggests that SEP latency is more vulnerable than SEP or MEP amplitude in ischemic conditions during scoliosis surgery.

Conclusion: In NMS patients, it should be considered that the bleeding amount can have a critical effect on intraoperative electrophysiological deterioration.
Files in This Item:
T9992022834.pdf Download
DOI
10.5535/arm.22100
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Park, Yoon Ghil(박윤길) ORCID logo https://orcid.org/0000-0001-9054-5300
Park, Jinyoung(박진영) ORCID logo https://orcid.org/0000-0003-4042-9779
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193914
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