Intraoperative Neurophysiological Monitoring to Prevent New Neurological Deficits in Spinal Tumor Cases

Elif Ilgaz Aydınlar; Pınar Yalınay Dikmen; Gökalp Sılav; Mehmet Zafer Berkman; İlhan Elmacı; Serdar Özgen

doi:10.4274/tnd.93798

Elif Ilgaz Aydınlar¹, Pınar Yalınay Dikmen¹, Gökalp Sılav², Mehmet Zafer Berkman³, İlhan Elmacı², Serdar Özgen²

¹Department Of Neurology, Acıbadem Üniversity School Of Medicine, Istanbul, Turkey
²Department Of Neurosurgery, Acıbadem Üniversity School Of Medicine, Istanbul, Turkey
³Department Of Neurosurgery, Acibadem Maslak Hospital, Istanbul, Turkey

Keywords: Intraoperative neurophysiological monitoring, spinal tumor, deficit

Abstract

OBJECTIVE: Intraoperative neurophysiological monitoring was carried out in patients with spinal cord tumors. These patients were retrospectively evaluated for postoperative new neurological deficits.

METHODS: A total of 32 spinal tumor cases (8 servical, 14 thoracal, 10 lumbosacral); 17 male,15 female patients; between 2-66 years of age (mean 44,1± 20) operated in our center were evaluated. All of our cases were monitored with somatosensory evoked potentials (SEP) muscular motor evoked potentials (MEP) and free run electromiyography. Spinal MEP (D wave), bulbocavernousus reflex (BCR) and pudental SEP were obtained in appropiate cases.

RESULTS: Five cases represented with temporary new neurological deficits postoperatively. All of these patients’ neurophysiological recording showed some temporary or permanent deterioration during surgery. None of our cases had a new permanent deficit, whereas the tumor was removed totally or almost totally in 26, subtotally in 4 and partially in 2 cases.

CONCLUSION: The functional integrity of the lateral and dorsal columns of the spine can be assest by SEP and muscular MEP recording. Additonal information about the neurological tissue is given by spinal MEP, BCR and pudental SEP in appropiate cases. We did not experience any false positive and negative results in our cases and we believe that the combined use of intraoperative spinal and MEP in spinal column located tumors gives reliable information about postoperative neurological outcome.