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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(3):581-588.
Intraoperative Monitoring Using Somatosensory Evoked Potential during Spinal Deformity Surgery.
Kim, Chul , Suk, Se Il , Hong, Ki Hyeok , Kim, Jin Hyok , Kim, Won Joong , Yi, Chang Heon , Kim, Chang Hyo
1Department of Rehabilitation Medicine, Inje University College of Medicine.
2Seoul Spine Institute, Inje University College of Medicine.
3Department of Anesthesiology, Inje University College of Medicine.
체성감각유발전위검사를 이용한 척추기형 교정수술 시의 수술중 감시
김철, 석세일1, 홍기혁2, 김진혁1, 김원중1, 이창헌, 김창효
인제대학교 의과대학 재활의학교실, 1서울척추센터, 2마취과학교실

Intraoperative monitoring using somatosensory evoked potential (SEP) study has been used increasingly to monitor neurological function during scoliosis surgery and other high-risk spinal surgeries. However, there are few studies related to this intraoperative monitoring, particularly in severe spinal deformity surgery, in Korea. So we evaluated the clinical efficacy of intraoperative SEP monitoring and considered the risk factors related to spinal surgery.

We performed a posterior tibial nerve somatosensory evoked potential study for intraoperative monitoring during surgical procedures in 101 patients (male 46, female 55).

Neurologic damage occurred in 16 patients (10 congenital scoliosis cases, 5 tuberculous kyphosis cases, and 1 degenerative spondylosis case) after surgical procedures. Delayed postoperative neurologic damage occurred in 4 patients (2 mild damage cases, 2 severe damage cases) among 85 cases which showed normal responses during surgical procedures. Sensitivity of this study was 75%, and specificity was 95.3%.

Somatosensory evoked potential study for intraoperaive monitoring is a sensitive and very useful method to detect iatrogenic lesions during spinal deformity surgery with satisfactory specificity. However, to improve the sensitivity and specificity of the intraoperative monitoring, combination of motor evoked potentials is recommended.

Key Words: Somatosensory evoked potentials, Intraoperative monitoring, Spinal surgery


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