Neurophysiological Intraoperative Monitoring in Patients with Cochlear Implant Undergoing Posterior Spinal Fusion: A Case Report.
Journal
JBJS case connector
ISSN: 2160-3251
Titre abrégé: JBJS Case Connect
Pays: United States
ID NLM: 101596828
Informations de publication
Date de publication:
20 01 2022
20 01 2022
Historique:
entrez:
20
1
2022
pubmed:
21
1
2022
medline:
5
4
2022
Statut:
epublish
Résumé
Transcranial electric stimulation motor-evoked potentials (tcMEPs) are the most sensitive technique in multimodality intraoperative neuromonitoring (IONM) for posterior spinal fusion (PSF). The presence of a cochlear implant (CI) is considered a contraindication to IONM because of theoretical risk of implant device and local tissue damage from voltages induced by tcMEPs. We present the case of a 10-year-old girl with CI who underwent successful PSF with tcMEP and monopolar electrocautery (MoEC) without perioperative complications or CI damage. With proper precautions, such as MoEC usage at a minimal voltage, motor-evoked potential monitoring can be safely performed in pediatric patients with CI undergoing PSF.
Identifiants
pubmed: 35050944
doi: 10.2106/JBJS.CC.21.00609
pii: 01709767-202203000-00016
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2022 by The Journal of Bone and Joint Surgery, Incorporated.
Déclaration de conflit d'intérêts
Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B793).
Références
Tamaki T, Noguchi T, Takano H, Tsuji H, Nakagawa T, Imai K, Inoue S. Spinal cord monitoring as a clinical utilization of the spinal evoked potential. Clin Orthop Relat Res. 1984;184:58-64.
Padberg AM, Wilson-Holden TJ, Lenke LG, Bridwell KH. Somatosensory and motor evoked potential monitoring without a wake-up test during idiopathic scoliosi surgery. Spine (Phila Pa 1976). 1992;23(12):1392-400.
Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE. Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol. 1995;96:6-11.
Diab M, Smith AR, Kuklo TR; The Spinal Deformity Study Group. Neural complications in the surgical treatment of adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2007;32:2759-63.
Qiu Y, Wang S, Wang B, Yu Y, Zhu F, Zhu Z. Incidence, risk factors of neurological deficits of surgical correction for scoliosis. Analysis of 1373 cases at one Chinese institution. Spine (Phila Pa 1976). 2008;33:519-26.
Schwartz DM, Auerbach JD, Dormans JP, Flynn J, Drummond DS, Bowe JA, Laufer S, Shah SA, Bowen JR, Pizzutillo PD, Jones KJ, Drummond DS. Neurophysiological detection of impending spinal cord injury during scoliosis surgery. J Bone Joint Surg Am. 2007;89:2440-9.
Pajewski TN, Arlet V, Phillips LH. Current approach on spinal cord monitoring: the point of view of the neurologist, the anesthesiologist and the spine surgeon. Eur Spine J. 2008;16(2):S115-29.
Schwartz D, Sestokas A, Dormans JP, Vaccaro AR, Hilibrand AS, Flynn JM, Li PM, Shah SA, Welch W, Drummond DS, Albert TJ. Transcranial electrical motor evoked potential monitoring during spine surgery. Spine (Phila Pa 1976). 2011;36(13):1046-9.
Sutter M, Deletis V, Dvorak J, Eggspuehler A, Grob D, Macdonald D, Mueller A, Sala F, Tamaki T. Current opinions and recommendations on multimodal intraoperative monitoring during spine surgeries. Eur Spine J. 2007;16(suppl 2):S232-7.
Murphy RF, Mooney JF. Complications following spine fusion for adolescent idiopathic scoliosis. Curr Rev Musculoskelet Med. 2016;9(4):462-9.
Francis L, Mohamed M, Patino M, McAuliffe J. Intraoperative neuromonitoring in pediatric surgery. Int Anesthesiol Clin. 2012;50(4):130-43.
Vauzelle C, Stagnara P, Jouvinroux P. Functional monitoring of spinal cord activity during spinal surgery. Clin Orthop Relat Res. 1973;93:173-8.
Jameson L. Transcranial motor evoked potentials. In: Koht A, Sloan TB, Toleikis JR, eds. Monitoring of the Nervous System for Anesthesiologists and Other Health Care Professionals. Berlin, Germany: Springer; 2012:27-45.
MacDonald DB. Intraoperative motor evoked potential monitoring: overview and update. J Clin Monit Comput. 2006;20(5):347-77.
Edwards D, Cortes M, Datta A, Minhas P, Wassermann EM, Bikson M. Physiological and modeling evidence for focal transcranial electrical brain stimulation in humans: a basis for high-definition tDCS. Neuroimage. 2013;74:266-75.
Andersson G, Ohlin A. Spatial facilitation of motor evoked responses in monitoring during spinal surgery. Clin Neurophysiol. 1999;110:720-4.
Hardesty CK, Gordon ZL, Poe-Kochert C, Son-Hing JP, Thompson GH. Bipolar sealer devices used in posterior spinal fusion for neuromuscular scoliosis reduce blood loss and transfusion requirements. J Pediatr Orthop. 2018;38(2):e78-82.
Jeyakumar A, Wilson M, Sorrel JE, McIntire JB, Jones DD, Brickman TM, Arriaga M. Monopolar cautery and adverse effects on cochlear implants. JAMA Otolaryngol Head Neck Surg. 2013;139:694-7.
Mangar D, Atlas GM, Kane PB. Electrocautery-induced pacemaker malfunction during surgery. Can J Anaesth. 1991;38:616-8.
Tien DA, Woodson EA, Anne S. Safety of monopolar electrocautery in patients with cochlear implants. Ann Otol Rhinol Laryngol. 2016;125:701-3.
Abiola G, Ward BK, Bowditch S, Ritzl EK, Carey JP. Safe intraoperative neurophysiologic monitoring during posterior spinal fusion in a patient with cochlear implants. Otol Neurotol. 2018;39(5):e314-8.
Studer D, Stieger C, Reichlin CJ, Terrier A, Allum JH. Spinal surgery with electrically evoked potential monitoring and monopolar electrocautery: is prior removal of a cochlear implant necessary? Otol Neurotol. 2019;40(1):e7-13.
Yellin JL, Wiggins CR, Franco AJ, Sankar WN. Safe transcranial electric stimulation motor evoked potential monitoring during posterior spinal fusion in two patients with cochlear implants. J Clin Monit Comput. 2016;30(4):503-6.
Allam A, Eldegwi A. Efficacy of using NRT thresholds in cochlear implants fitting, in prelingual pediatric patients. J Otol. 2019;14(4):128-35.