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Transcranial magnetic stimulation in the semi-quantitative, pre-operative assessment of patients undergoing spinal deformity surgery.
Eur Spine J ; 26(8): 2103-2111, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27554347
ABSTRACT

PURPOSE:

To compare measurements of motor evoked potential latency stimulated either magnetically (mMEP) or electrically (eMEP) and central motor conduction time (CMCT) made pre-operatively in conscious patients using transcranial and intra-operatively using electrical cortical stimulation before and after successful instrumentation for the treatment of adolescent idiopathic scoliosis.

METHODS:

A group initially of 51 patients with adolescent idiopathic scoliosis aged 12-19 years was evaluated pre-operatively in the outpatients' department with transcranial magnetic stimulation. The neurophysiological data were then compared statistically with intra-operative responses elicited by transcranial electrical stimulation both before and after successful surgical intervention. MEPs were measured as the cortically evoked compound action potentials of Abductor hallucis. Minimum F-waves were measured using conventional nerve conduction methods and the lower motor neuron conduction time was calculated and this was subtracted from MEP latency to give CMCT.

RESULTS:

Pre-operative testing was well tolerated in our paediatric/adolescent patients. No neurological injury occurred in any patient in this series. There was no significant difference in the values of mMEP and eMEP latencies seen pre-operatively in conscious patients and intra-operatively in patients under anaesthetic. The calculated quantities mCMCT and eCMCT showed the same statistical correlations as the quantities mMEP and eMEP latency.

CONCLUSIONS:

The congruency of mMEP and eMEP and of mCMCT and eCMCT suggests that these measurements may be used comparatively and semi-quantitatively for the comparison of pre-, intra-, and post-operative spinal cord function in spinal deformity surgery.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Escoliose / Potencial Evocado Motor / Assistência Perioperatória / Estimulação Magnética Transcraniana / Monitorização Neurofisiológica Intraoperatória Aspecto clínico: Terapia Limite: Adolescente / Adulto / Criança / Feminino / Humanos / Masculino / Jovem adulto Idioma: Inglês Revista: Eur Spine J Assunto da revista: Ortopedia Ano de publicação: 2017 Tipo de documento: Artigo País de afiliação: Reino Unido