Relevant bibliographies by topics / Evoked potentials (Electrophysiology) Scoliosis Patient monitoring

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Academic literature on the topic 'Evoked potentials (Electrophysiology) Scoliosis Patient monitoring'

Author: Grafiati
Published: 4 June 2021
Last updated: 8 February 2022

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Journal articles on the topic "Evoked potentials (Electrophysiology) Scoliosis Patient monitoring"

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Thirumala, Parthasarathy D., Donald J. Crammond, Yoon K. Loke, Hannah L. Cheng, Jessie Huang, and Jeffrey R. Balzer. "Diagnostic accuracy of motor evoked potentials to detect neurological deficit during idiopathic scoliosis correction: a systematic review." Journal of Neurosurgery: Spine 26, no. 3 (2017): 374–83. http://dx.doi.org/10.3171/2015.7.spine15466.

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OBJECTIVE The goal of this study was to evaluate the efficacy of intraoperative transcranial motor evoked potential (TcMEP) monitoring in predicting an impending neurological deficit during corrective spinal surgery for patients with idiopathic scoliosis (IS). METHODS The authors searched the PubMed and Web of Science database for relevant lists of retrieved reports and/or experiments published from January 1950 through October 2014 for studies on TcMEP monitoring use during IS surgery. The primary analysis of this review fit the operating characteristic into a hierarchical summary receiver operating characteristic curve model to determine the efficacy of intraoperative TcMEP-predicted change. RESULTS Twelve studies, with a total of 2102 patients with IS were included. Analysis found an observed incidence of neurological deficits of 1.38% (29/2102) in the sample population. Of the patients who sustained a neurological deficit, 82.8% (24/29) also had irreversible TcMEP change, whereas 17.2% (5/29) did not. The pooled analysis using the bivariate model showed TcMEP change with sensitivity (mean 91% [95% CI 34%–100%]) and specificity (mean 96% [95% CI 92–98%]). The diagnostic odds ratio indicated that it is 250 times more likely to observe significant TcMEP changes in patients who experience a new-onset motor deficit immediately after IS correction surgery (95% CI 11–5767). TcMEP monitoring showed high discriminant ability with an area under the curve of 0.98. CONCLUSIONS A patient with a new neurological deficit resulting from IS surgery was 250 times more likely to have changes in TcMEPs than a patient without new deficit. The authors' findings from 2102 operations in patients with IS show that TcMEP monitoring is a highly sensitive and specific test for detecting new spinal cord injuries in patients undergoing corrective spinal surgery for IS. They could not assess the value of TcMEP monitoring as a therapeutic adjunct owing to the limited data available and their study design.
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Park, Paul, Anthony C. Wang, Jaypal Reddy Sangala, et al. "Impact of multimodal intraoperative monitoring during correction of symptomatic cervical or cervicothoracic kyphosis." Journal of Neurosurgery: Spine 14, no. 1 (2011): 99–105. http://dx.doi.org/10.3171/2010.9.spine1085.

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Object Surgical correction of symptomatic cervical or cervicothoracic kyphosis involves the potential for significant neurological complications. Intraoperative monitoring has been shown to reduce the risk of neurological injury in scoliosis surgery, but it has not been well evaluated during surgery for cervical or cervicothoracic kyphosis. In this article, the authors review a cohort of patients who underwent kyphosis correction with multimodal intraoperative monitoring (MIOM). Methods Twenty-nine patients were included in the study. Preoperative and postoperative Cobb angles were measured to determine the extent of correction. Multimodal intraoperative monitoring consisted of somatosensory evoked potentials, transcranial motor evoked potentials (tMEPs), and electromyography activity. Sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) were assessed for each monitoring modality. Results The mean patient age was 58.0 years, and 20 patients were female. The mean pre- and postoperative sagittal Cobb angles were 41.3° and 7.3°, respectively. A total of 8 intraoperative monitoring alerts were observed. Transcranial MEPs yielded a sensitivity of 75%, specificity of 84%, PPV of 43%, and NPV of 95%. Somatosensory evoked potentials had a sensitivity of 25%, specificity of 96%, PPV of 50%, and NPV of 88%. Electromyography resulted in a sensitivity of 0%, specificity of 93%, PPV of 0%, and NPV of 96%. Changes in tMEPs led to successful intervention in 2 cases. There was 1 case in which a C-8 palsy occurred without any changes in MIOM. Conclusions In contrast to sensitivity and PPV, specificity and NPV were generally high in all 3 monitoring modalities. Both false-positive and false-negative results occurred. Transcranial MEP monitoring was the most useful modality and appeared to allow successful intervention in certain cases. Larger, prospective comparative studies are necessary to determine whether MIOM truly decreases the rate of neurological complications and is therefore worth the added economic cost and intraoperative time.
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Tsirikos, Athanasios I., Andrew D. Duckworth, Lindsay E. Henderson, and Ciara Michaelson. "Multimodal Intraoperative Spinal Cord Monitoring during Spinal Deformity Surgery: Efficacy, Diagnostic Characteristics, and Algorithm Development." Medical Principles and Practice 29, no. 1 (2019): 6–17. http://dx.doi.org/10.1159/000501256.

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Objective: This study aims to present the diagnostic characteristics of multimodal intraoperative monitoring (IOM) in spinal deformity surgery and to define and categorise the neuromonitoring events, as well as propose an algorithm of action. Materials and Methods: We reviewed 1,155 consecutive patients (807 female, 348 male) who underwent deformity correction using standardised perioperative care, cortical/cervical somatosensory evoked potentials (SSEPs), and upper/lower limb transcranial electrical motor evoked potential (MEPs) by a single surgeon. The mean age at surgery was 13.8 years (range 10–23.3). We categorised IOM events as true, transient true, and false positive or negative. Diagnostic performance criteria were calculated. Results: The most common diagnosis was adolescent idiopathic scoliosis in 717 (62%) patients. We identified 3 true positive monitoring events occurring in 2 patients (0.17%), 8 transient true positive (0.69%), and 8 transient false positive events (0.69%). There were no false negative events and no patient had postoperative neurological complications. The multimodal IOM technique had a sensitivity of 100%, specificity of 99.3%, positive predictive value of 55.6%, and negative predictive value of 100%. Sensitivity was 100% for MEPs and multimodal monitoring compared to 20% for cortical or cervical SSEPs. The frequency of true or transient true positive events was higher (p = 0.07) in Scheuermann’s kyphosis (3/91 patients, 3.3%) compared to adolescent idiopathic scoliosis (6/717 patients, 0.84%). Conclusion: Multimodal IOM is highly sensitive and specific for spinal cord injury. This technique is reliable for the assessment of the condition of the spinal cord during major deformity surgery. We propose an algorithm of intraoperative action to allow close cooperation between the surgical, anaesthetic, and neurophysiology teams and to prevent neurological deficits.
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Ferguson, Joseph, Steven W. Hwang, Zachary Tataryn, and Amer F. Samdani. "Neuromonitoring changes in pediatric spinal deformity surgery: a single-institution experience." Journal of Neurosurgery: Pediatrics 13, no. 3 (2014): 247–54. http://dx.doi.org/10.3171/2013.12.peds13188.

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Object Intraoperative monitoring of the spinal cord has become the standard of care during surgery for pediatric spinal deformity correction. The use of both somatosensory and motor evoked potentials has dramatically increased the sensitivity and specificity of detecting intraoperative neurophysiological changes to the spinal cord, which assists in the intraoperative decision-making process. The authors report on a large, single-center experience with neuromonitoring changes and outline the surgical management of patients who experience significant neuromonitoring changes during spinal deformity correction surgery. Methods The authors conducted a retrospective review of all cases involving pediatric patients who underwent spinal deformity correction surgery at Shriners Hospital for Children, Philadelphia, between January 2007 and March 2010. Five hundred nineteen consecutive cases were reviewed in which neuromonitoring was used, with 47 cases being identified as having significant changes in somatosensory evoked potentials, motor evoked potentials, or both. These cases were reviewed for patient demographic data and surgical characteristics. Results The incidence of significant neuromonitoring changes was 9.1% (47 of 519 cases), including 6 cases of abnormal Stagnara wake-up tests, of which 4 had corroborated postoperative neurological deficits (8.5% of 47 cases, 0.8% of 519). In response to neuromonitoring changes, wake-up tests were performed in 37 (79%) of 47 cases, hardware was adjusted in 15 (32%), anesthesiology interventions were reported in 5 (11%), hardware was removed in 5 (11%), the patient was successfully repositioned in 3 (6%), and the procedure was aborted in 13 (28%). In 1 of the 4 patients with new postoperative deficits, the deficit had fully resolved by the last follow-up; the other 3 patients had persistent neurological impairment as of the most recent follow-up examination. The authors observed a sensitivity of 100% for intraoperative neuromonitoring. Conclusions Due to the profound risks associated with spinal deformity surgery, intraoperative neurophysiological monitoring is an integral tool to warn of impending spinal cord injury. Intraoperative neuromonitoring appears to provide a safe and useful warning mechanism to minimize spinal cord injury that may arise during scoliosis correction surgery in pediatric patients.
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Galassi, Giuliana, Eleni Georgoulopoulou, and Alessandra Ariatti. "Amiodarone neurotoxicity: the other side of the medal." Open Medicine 9, no. 3 (2014): 437–42. http://dx.doi.org/10.2478/s11536-013-0306-y.

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AbstractThe efficacy of amiodarone is tempered by its toxicity, with 50% of long-term users discontinuing the drug. The non-cardiac side effects of amiodarone may involve central and peripheral nervous system. We studied two patients treated with amiodarone for 46 and 15 months respectively. Both patients exhibited progressive distal extremity weakness, impaired perception, loss of deep reflexes. Electrophysiology identified a widespread, sensorimotor polyneuropathy with features of axonal loss and demyelination. Visual evoked potentials (VEPs) showed prolonged P100 latency bilaterally in absence of visual symptoms or brain magnetic resonance imaging (MRI) abnormalities. Extensive laboratory examinations excluded known causes of peripheral neuropathies. At 21 months after amiodarone withdrawal, P100 latency of case 1 VEPs returned to normal, whereas polyneuropathy continued to progress. In the second patient neuropathy has worsened similarly over 2 years whereas P100 latency of VEPs recovered to normal within 7 months after withdrawal of amiodarone. These findings may suggest different mechanisms of toxicity, which could be due to amiodarone pharmacokinetic and its metabolite effects on the peripheral nerves, as opposed to the optic nerve. We emphasize that use of amiodarone needs monitoring of patients at risk of development side effects.
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Lehner, Kurt R., Erin M. Yeagle, Miklos Argyelan, et al. "Validation of corpus callosotomy after laser interstitial thermal therapy: a multimodal approach." Journal of Neurosurgery 131, no. 4 (2019): 1095–105. http://dx.doi.org/10.3171/2018.4.jns172588.

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ObjectiveDisconnection of the cerebral hemispheres by corpus callosotomy (CC) is an established means to palliate refractory generalized epilepsy. Laser interstitial thermal therapy (LITT) is gaining acceptance as a minimally invasive approach to treating epilepsy, but this method has not been evaluated in clinical series using established methodologies to assess connectivity. The goal in this study was to demonstrate the safety and feasibility of MRI-guided LITT for CC and to assess disconnection by using electrophysiology- and imaging-based methods.MethodsRetrospective chart and imaging review was performed in 5 patients undergoing LITT callosotomy at a single center. Diffusion tensor imaging and resting functional MRI were performed in all patients to assess anatomical and functional connectivity. In 3 patients undergoing simultaneous intracranial electroencephalography monitoring, corticocortical evoked potentials and resting electrocorticography were used to assess electrophysiological correlates.ResultsAll patients had generalized or multifocal seizure onsets. Three patients with preoperative evidence for possible lateralization underwent stereoelectroencephalography depth electrode implantation during the perioperative period. LITT ablation of the anterior corpus callosum was completed in a single procedure in 4 patients. One complication involving misplaced devices required a second procedure. Adequacy of the anterior callosotomy was confirmed using contrast-enhanced MRI and diffusion tensor imaging. Resting functional MRI, corticocortical evoked potentials, and resting electrocorticography demonstrated functional disconnection of the hemispheres. Postcallosotomy monitoring revealed lateralization of the seizures in all 3 patients with preoperatively suspected occult lateralization. Four of 5 patients experienced > 80% reduction in generalized seizure frequency. Two patients undergoing subsequent focal resection are free of clinical seizures at 2 years. One patient developed a 9-mm intraparenchymal hematoma at the site of entry and continued to have seizures after the procedure.ConclusionsMRI-guided LITT provides an effective minimally invasive alternative method for CC in the treatment of seizures associated with drop attacks, bilaterally synchronous onset, and rapid secondary generalization. The disconnection is confirmed using anatomical and functional neuroimaging and electrophysiological measures.
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Lopez-Gonzalez, Miguel Angel, Xiaochun Zhao, Dinesh Ramanathan, Timothy Marc Eastin, and Song Minwoo. "High flow bypass for right giant cavernous internal carotid artery aneurysm with fibromuscular dysplasia of cervical internal carotid artery: microsurgical 2-D video." Surgical Neurology International 11 (July 4, 2020): 177. http://dx.doi.org/10.25259/sni_141_2020.

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Background: It is well known that intracranial aneurysms can be associated to fibromuscular dysplasia (FMD). Nevertheless, it is not clear the best treatment strategy when there is an association of giant symptomatic cavernous carotid aneurysm with extensive cervical internal carotid artery (ICA) FMD. Case Description: We present the case of 63 year-old right-handed female with hypothyroidism, 1 month history of right-sided pulsatile headache and visual disturbances with feeling of fullness sensation and blurry vision. Her neurological exam showed partial right oculomotor nerve palsy with mild ptosis, asymmetric pupils (right 5 mm and left 3mm, both reactive), and mild exotropia, normal visual acuity. Computed tomography angiogram and conventional angiogram showed 2.5 × 2.6 × 2.6 cm non-ruptured aneurysm arising from cavernous segment of the right ICA. She had right hypoplastic posterior communicant artery, and collateral flow through anterior communicant artery during balloon test occlusion and the presence of right cervical ICA FMD. The patient was started on aspirin. After lengthy discussion of treatment options in our neurovascular department, between observations, endovascular treatment with flow diverter device, or high flow bypass, recommendation was to perform high flow bypass and patient consented for the procedure. We performed right-sided pterional trans-sylvian microsurgical approach and right neck dissection at common carotid bifurcation under electrophysiology monitoring (somatosensory evoked potentials and electroencephalography); while vascular surgery department assisted with the radial artery graft harvesting. The radial artery graft was passed through preauricular tunnel, cranially was anastomosed at superior trunk of middle cerebral artery, and caudally at external carotid artery (Video). Intraoperative angiogram showed adequate bypass patency and lack of flow within aneurysm. The patient was extubated postoperatively and discharged home with aspirin in postoperative day 5. Improvement on oculomotor deficit was complete 3 weeks after surgery. Conclusion: Nowadays, endovascular therapy can manage small to large cavernous ICA aneurysms even if associated to FMD, although giant symptomatic cavernous carotid aneurysms impose a different challenge. Here, we present the management for the association of symptomatic giant cavernous ICA aneurysm and cervical ICA FMD with high flow bypass. We consider important to keep the skills in the cerebrovascular neurosurgeon armamentarium for the safe management of these lesions.
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Dissertations / Theses on the topic "Evoked potentials (Electrophysiology) Scoliosis Patient monitoring"

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Hu, Yong. "Investigation of the reliability of spinal cord monitoring during scoliosis surgery /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2145162X.

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胡勇 and Yong Hu. "Investigation of the reliability of spinal cord monitoring during scoliosis surgery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31240343.

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Books on the topic "Evoked potentials (Electrophysiology) Scoliosis Patient monitoring"

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E, Maynard Douglas, ed. Monitoring cerebral function: Long-term monitoring of EEG and evoked potentials. Elsevier, 1986.

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Evoked potential monitoring in the operating room. Raven Press, 1986.

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Cerebral monitoring in the operating room and the intensive care unit. Kluwer Academic Publishers, 1990.

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Prior, Pamela F., and Douglas E. Maynard. Monitoring Cerebral Function: Long-Term Monitoring of Eeg and Evoked Potentials. Elsevier Science Ltd, 1987.

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R, Dimitrijevic Milan, and Halter J. A. 1956-, eds. Atlas of human spinal cord evoked potentials. Butterworth-Heinemann, 1995.

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1946-, Schramm J., Jones S. J, and International Symposium on Spinal Cord Monitoring (2nd : 1984 : Erlangen, Germany), eds. Spinal cord monitoring. Springer-Verlag, 1985.

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1935-, Shimoji Kōki, and International Symposium on Spinal Cord Monitoring and Electrodiagnosis (4th : 1989 : Niigata-shi, Japan), eds. Spinal cord monitoring and electrodiagnosis. Springer-Verlag, 1991.

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1935-, Shimoji Kōki, and International Symposium on Spinal Cord Monitoring and Electrodiagnosis (4th : 1989 : Niigata-shi, Japan), eds. Spinal cord monitoring and electrodiagnosis. Springer-Verlag, 1991.

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Schulte am Esch, J. 1939- and Kochs E. 1943-, eds. Central nervous system monitoring in anesthesia and intensive care. Springer-Verlag, 1994.

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E, Desmedt John, ed. Neuromonitoring in surgery. Elsevier, 1989.

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