MONITORING OF SPINAL CORD FUNCTIONAL STATUS IN PATIENTS WITH INTRAMEDULLARY TUMORS
https://doi.org/10.14531/ss2009.2.83-90
Abstract
Objective. To analyze disorders in spinal cord function in patients with intramedullary tumors (IMT) and to ascertain informative value of intraoperative monitoring of somatosensory evoked potentials (SSEPs) for prevention of neurological complications during tumor removal using infrared laser irradiation.
Material and Methods. SSEPs were recorded from upper and/or lower extremity nerve stimulation in 38 patients with IMT of different localization before surgery, during operation, at 14 to 28 days after surgery, and at long-term follow-up period. The nature and the rate of spinal cord conduction abnormality depending on the tumor localization and volume were analyzed.
Results. Postoperative examination showed a positive dynamics of SSEP parameters in 14.0 % of patients, and the absence of significant changes – in 65.6 %. It was found that SSEP responses can reflect short-term effects of surgical manipulations before a direct tumor removal, and of arterial pressure. Long-lasting anesthesia progressively increases SSEP delay time. These factors are taken into account in determining a threshold for functional permissibility of intervention at the stage of tumor removal and at the final stage when laser radiation is applied. Changes were assessed by comparison with parameters obtained just before a given stage.
Conclusion. Monitoring of SSEPs at main stages of surgery allowed avoiding additional traumatization of the spinal cord, performing total removal of the tumor, preventing its continuous growth, and achieving of good long-term clinical results of the treatment.
About the Authors
Sergey Borisovich Tsvetovsky
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
Vyacheslav Vladimirovich Stupak
Novosibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
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Review
For citations:
Tsvetovsky S.B., Stupak V.V. MONITORING OF SPINAL CORD FUNCTIONAL STATUS IN PATIENTS WITH INTRAMEDULLARY TUMORS. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2009;(2):083-090. (In Russ.) https://doi.org/10.14531/ss2009.2.83-90
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