Somatosensory evoked potential monitoring during positioning of the patient for posterior fossa surgery in the semisitting position

Neurosurgery
W DeinsbergerD K Böker

Abstract

Midcervical flexion myelopathy is a rare but well-known complication of posterior fossa surgery. To reduce the risk, we routinely used somatosensory evoked potential (SSEP) monitoring during positioning of the patient. Fifty-five consecutive patients were operated on for posterior fossa lesions in the semisitting position via a median (5 patients) or a lateral (50 patients) suboccipital approach. During positioning, monitoring of SSEPs by stimulation of the tibial nerve (T-SSEP) as well as by stimulation of the median nerve (M-SSEP) was established. In the case of pronounced SSEP changes, the head was repositioned. Surgery was started after SSEP recordings were unchanged as compared to the baseline investigation. Effective monitoring was possible in all cases. Whereas M-SSEP recordings showed no changes while placing patients in the sitting position, T-SSEP recordings were altered in 14 cases (25%). In cases using the midline approach, SSEP changes were never so pronounced to require repositioning of the head. Head flexion and rotation resulted in significant changes of T-SSEP recordings in eight patients (14.5%), requiring repositioning. In two cases, an amplitude loss was noted. In only two of these eight patients were M-SSEP...Continue Reading

References

Feb 1, 1980·Archives of Otolaryngology·W E Hitselberger, W F House

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Citations

Oct 8, 2011·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Francesco SalaMassimo Gerosa
Apr 20, 2020·World Neurosurgery·Alexander T Yahanda, Michael R Chicoine
Jan 29, 2002·Anesthesia and Analgesia·S MératL Brinquin
Mar 20, 2004·Physical Medicine and Rehabilitation Clinics of North America·Jefferson C Slimp

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