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Neuromonitoring During Surgery for Paediatric Spinal Deformity in Canada (2007)

Published online by Cambridge University Press:  02 December 2014

Jonathan Norton  and
Douglas Hedden
Jonathan Norton*
Affiliation:
Division of Pediatric Surgery, Stollery Children's Hospital, Edmonton, Alberta, Canada
Douglas Hedden
Affiliation:
Division of Pediatric Surgery, Stollery Children's Hospital, Edmonton, Alberta, Canada
*
Pediatric Surgery, 2C3 North, WMC Health Sciences Centre, University of Alberta Hospital, 8440 112th Street, Edmonton, Alberta T6G 2S2, Canada
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Abstract

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Background:

Neuromonitoring during paediatric (and adult) spinal deformity surgery helps to reduce the risk of both permanent and short term neurological damage. A shortage of neurophysiologists and technicians limits the availability of this service. Not all surgeons believe neuromonitoring offers neuroprotection during spinal surgery. This study aimed to document the degree to which paediatric patients undergoing spinal deformity correction surgery have their spinal cord function monitored.

Methods:

A questionnaire was sent electronically to all of the surgical members of the Canadian Paediatric Spinal Deformity Study Group.

Results:

Results were received from 9/9 centres indicating that monitoring was performed in 7/9 centres, with one further centre awaiting staffing. Whilst half of those centres that do monitor only monitor sensory and motor evoked potentials, the remaining centres also use EMG and EEG to assess the state of the patient intraoperatively.

Conclusions:

Despite a shortage of staff, most paediatric spinal deformity surgeons in Canada who wish to, are able to neurophysiologically monitor their surgical cases. Neuromonitoring appears to be becoming a standard of care, at least for paediatric spinal deformity surgery. There is an urgent need for the establishment of national standards for both technologists and interpreters, as well as training programmes for both these groups.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 1 , January 2009 , pp. 47 - 50
Copyright
Copyright © The Canadian Journal of Neurological 2009

References

1.Dawson, EG, Sherman, JE, Kanim, LEA, Nuwer, MR.Spinal cord monitoring: results of the scoliosis research society and the European spinal deformity society survey. Spine. 1991; 16(8): S361–4.Google Scholar
2.Legatt, AD.Current practice of motor evoked potential monitoring: results of a survey. J Clin Neurophysiol. 2002;19(5):454–60.Google Scholar
3.MacDonald, DB.Safety of intraoperative transcranial electrical stimulation motor evoked potential monitoring. J Clin Neurophysiol. 2002;19(5):416–29.Google Scholar
4.Lo, YL, Dan, YF, Tan, YE, Nurjannah, S, Tan, SB, Tan, CT, et al.Intraoperative motor-evoked potential monitoring in scoliosis surgery: comparison of desflourane/nitrous oxide with propofol total intravenous anesthetic regimens. J Neurosurg Anesthesiol. 2006;18(3):211–14.Google Scholar
5.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. 2007; S2:115–29.Google Scholar
6.DiCindio, S, Schwartz, DM.Anesthetic management for pediatric spinal fusion: implications of advances in spinal cord monitoring. Anesthesiol Clin North America. 2005; 23(4): 765–87.Google Scholar
7.MacDonald, DB.Intraoperative motor evoked potential monitoring: overview and update. J Clin Monit Comput. 2006; 20(5): 347–77.Google Scholar
8.Nuwer, MR, Daube, J, Fischer, C, Schramm, J, Yingling, CD.Neuromonitoring during surgery. Report of an IFCN Committee. Electroencephalogr Clin Neurophysiol. 1993;87(5):263–76.Google Scholar
9.Skinner, SA, Nagib, M, Bergman, TA, Maxwell, RE, Msangi, G.The initial use of free-running e ectromyography to detect early motor tract injury during resection of intramedullary spinal cord lesions. Neurosurgery. 2005; 56(Operative Neurosurgery 2): 299–314.Google Scholar
10.Holland, NR.Intraoperative electromyography. J Clin Neurophys. 2002;19(5):444–53.Google Scholar
11.Chan, KM, Warren, S, Young, GB.National manpower survey on clinical neurophysiology laboratories in Canada. Can J Neurol Sci 2007; 34(2): 106.Google Scholar
12.Rossini, PM, Barker, AT, Berardelli, A, Caramia, MD, Caruso, G, Cracco, RQ, et al.Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic prinicples and procedures for routine clinical application. Report of an IFCN committee. Electroencephalogr. 1994;91:92–.Google Scholar
13.Rothwell, J.Techniques and mechanisms of action of transcranial stimulation of the human motor cortex. J Neurosci Methods. 1997;74:22–.Google Scholar
14.Szelenyi, A, Camargo, AB, Deletis, V.Neurophysiological evaluation of the corticospinal tract by D-wave recordings in young children. Childs Nerv Syst. 2003;19(1):30–4.CrossRefGoogle ScholarPubMed
15.Nuwar, MR.Regulatory and medical-legal aspects of intraoperative monitoring. J Clin Neurophys. 2002;19(5):387–95.Google Scholar
16.Shi, YS, Binette, M, Martin, WH, Pearson, JM, Hart, RA.Electrical stimulation for intraoperative evaluation of thoracic pedicle screw placement. Spine. 2003;28(6):595–601.Google Scholar
17.Miller, A, Sleigh, JW, Barnard, J, Steyn-Ross, DA.Does bispectral analysis of the electroencephalogram add anything but complexity? B J Anaesth. 2004;92(1):8–13.CrossRefGoogle ScholarPubMed
18.Sala, F, Dvorak, J, Faccioli, F.Cost effectiveness of multimodal intraoperative monitoring during spine surgery. Eur Spine J. 2007; 16(S2):229–31.Google Scholar
19.Magit, DP, Hilibrand, AS, Kirk, J, Rechtine, G, Albert, TJ, Vaccaro, AR, et al.Questionnaire study of neuromonitoring availability and usage for spine surgery. J Spinal Disord Tech. 2007; 20(4): 282–9.CrossRefGoogle ScholarPubMed
20.Sala, F, Bricolo, A, Faccioli, F, Lanteri, P, Gerosa, M.Surgery for intramedullary spinal cord tumors: the role of intraoperative (neurophysiological) monitoring. Eur Spine J. 2007; S2:130–9.Google Scholar
21.Edmonds, HL.Protective effects of neuromonitoring during cardiac surgery. Ann NY Acad Sci. 2005;1053:19–.CrossRefGoogle ScholarPubMed
22.Dong, CCJ, MacDonald, DB, Akagami, R, Westerberg, B, AlKhani, A, Kanaan, I, et al.Intraoperative facial motor evoked potential monitoring with transcranial electrical stimulation during skull base surgery. Clin Neurophysiol. 2005;116(3):588–96.Google Scholar