Tongue laceration occurred during spinal surgery with intraoperative neurophysiological monitoring

Abstract

In two separate cases, two male patients with cervical myelopathy, aged 62 and 53, respectively, and with underlying causes including herniated cervical discs and foraminal stenosis, underwent surgical decompression with intraoperative neurophysiological monitoring (IONM). Transcranial electrical stimulation (TES) for motor evoked potentials was employed during the surgical procedures. Both patients experienced intraoperative tongue lacerations, necessitating subsequent suturing. Despite advancements in IONM techniques, there remain incidents of bite injuries during TES, with tongue injuries being a recognized hazard. The precise cause remains elusive but is attributed to repeated TES, patient positioning, or inappropriate use of bite blocks. Proper positioning of the bite block is crucial in preventing such injuries. Though existing bite block models provide a degree of protection, there is a growing need for more tailored designs that adapt to the individual patients.