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Journal of the Korean Academy of Rehabilitation Medicine 1997;21(6):1231-1235.
Clinical Significance of Electrophysiologic Monitoring during Surgery for Lower Thoracic Cord Tumor: Report of Three Cases.
Lee, Young Hee , Lee, Jong Min , Oh, Han Seon
Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Korea.
하흉수의 척수종양 수술중 전기생리학적 감시의 임상적 중요성 ⁣증례 보고⁣
이영희, 이종민, 오한선
연세대학교 원주의과대학 재활의학교실
Abstract

Electrophysiologic monitoring during surgery for the spinal cord tumor is necessary for identification of the nerve root, prevention of the nerve injury, and prediction of postoperative prognosis. In other countries, intraoperative electrophysiologic monitorings are commonly done in various cases such as selective posterior rhizotomy, scoliosis, sponlylolisthesis, lipomeningocele, and spinal cord tumor, but it is not a common procedure in Korea except for the selective posterior rhizotomy.

We report 3 cases of electrophysiologic monitoring during sugery for the spinal cord tumor at lower thoracic level. Using multichannel EMG machine, we recorded free-run EMG, somatosensory evoked potential(SSEP) of tibial nerve, and compound motor unit action potential (CMAP) of various regions such as abdomen, lower extremity, and anus, stimulating nerve roots at the lower thoracic level.

We identified CMAP from rectus abdominis muscles only in the first case, but in the second case, we identified CMAP from tibialis anterior and gastrocnemius muscles which avoided the injury to lumbosacral roots. In the third case, SSEP improved immediately after we removed the mass at lower thoracic level.

We concluded that intraoperative electrophysiologic monitoring combined with recording CMAP is a useful procedure to minimize neural tissue damage during surgery for the spinal cord tumor at lower thoracic level.

Key Words: Intraoperative monitoring, Spinal cord tumor


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