The Experts below are selected from a list of 1683 Experts worldwide ranked by ideXlab platform
Michael D Millen - One of the best experts on this subject based on the ideXlab platform.
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femoral artery ischemia during Spinal scoliosis surgery detected by posterior tibial nerve somatosensory evoked potential monitoring
Spine, 2000Co-Authors: David G Vossler, Thomas Stonecipher, Michael D MillenAbstract:Study Design. A case report of unilateral leg ischemia caused by femoral artery compression detected using posterior tibial nerve somatosensory-evoked potentials during Spinal scoliosis instrumentation surgery. Objectives. To report a rare cause of intraoperative unilateral loss of all posterior tibial nerve somatosensory-evoked potential waveforms. Summary of Background Data. Failure to obtain adequate popliteal fossa, Spinal, subcortical, and cortical potentials during posterior tibial nerve somatosensory-evoked potential Spinal cord monitoring usually results from technical factors or chronic conditions affecting the peripheral nerve. Methods. A 16-year-old boy with thoracic scoliosis had normal posterior tibial nerve somatosensory-evoked potentials both before surgery and in the operating room immediately after anesthesia induction and prone positioning on a four-post Spinal Frame. Results. One hour after the start of surgery, a minimal amplitude reduction of the right popliteal fossa potentials appeared. Fifteen minutes later, the amplitudes of the popliteal fossa, subcortical, and cortical potentials evoked by right posterior tibial nerve stimulation became substantially reduced. Subsequently, all waveforms were lost. Malfunction of the right posterior tibial nerve stimulator was initially suspected, but when proper function was verified, a search for other causes of this loss led to discovery of leg ischemia. The patient was repositioned on the Spinal Frame, and all posterior tibial nerve somatosensory-evoked potentials waveforms began to reappear 7 minutes later. There was no postoperative clinically detectable complication. Conclusions. Although technical malfunction should always be suspected when all intraoperative somatosensory-evoked potential waveforms are initially seen and subsequently lost, one should also consider the possibility that intraoperative ischemia due to limb positioning could be the etiology.
David G Vossler - One of the best experts on this subject based on the ideXlab platform.
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femoral artery ischemia during Spinal scoliosis surgery detected by posterior tibial nerve somatosensory evoked potential monitoring
Spine, 2000Co-Authors: David G Vossler, Thomas Stonecipher, Michael D MillenAbstract:Study Design. A case report of unilateral leg ischemia caused by femoral artery compression detected using posterior tibial nerve somatosensory-evoked potentials during Spinal scoliosis instrumentation surgery. Objectives. To report a rare cause of intraoperative unilateral loss of all posterior tibial nerve somatosensory-evoked potential waveforms. Summary of Background Data. Failure to obtain adequate popliteal fossa, Spinal, subcortical, and cortical potentials during posterior tibial nerve somatosensory-evoked potential Spinal cord monitoring usually results from technical factors or chronic conditions affecting the peripheral nerve. Methods. A 16-year-old boy with thoracic scoliosis had normal posterior tibial nerve somatosensory-evoked potentials both before surgery and in the operating room immediately after anesthesia induction and prone positioning on a four-post Spinal Frame. Results. One hour after the start of surgery, a minimal amplitude reduction of the right popliteal fossa potentials appeared. Fifteen minutes later, the amplitudes of the popliteal fossa, subcortical, and cortical potentials evoked by right posterior tibial nerve stimulation became substantially reduced. Subsequently, all waveforms were lost. Malfunction of the right posterior tibial nerve stimulator was initially suspected, but when proper function was verified, a search for other causes of this loss led to discovery of leg ischemia. The patient was repositioned on the Spinal Frame, and all posterior tibial nerve somatosensory-evoked potentials waveforms began to reappear 7 minutes later. There was no postoperative clinically detectable complication. Conclusions. Although technical malfunction should always be suspected when all intraoperative somatosensory-evoked potential waveforms are initially seen and subsequently lost, one should also consider the possibility that intraoperative ischemia due to limb positioning could be the etiology.
Thomas Stonecipher - One of the best experts on this subject based on the ideXlab platform.
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femoral artery ischemia during Spinal scoliosis surgery detected by posterior tibial nerve somatosensory evoked potential monitoring
Spine, 2000Co-Authors: David G Vossler, Thomas Stonecipher, Michael D MillenAbstract:Study Design. A case report of unilateral leg ischemia caused by femoral artery compression detected using posterior tibial nerve somatosensory-evoked potentials during Spinal scoliosis instrumentation surgery. Objectives. To report a rare cause of intraoperative unilateral loss of all posterior tibial nerve somatosensory-evoked potential waveforms. Summary of Background Data. Failure to obtain adequate popliteal fossa, Spinal, subcortical, and cortical potentials during posterior tibial nerve somatosensory-evoked potential Spinal cord monitoring usually results from technical factors or chronic conditions affecting the peripheral nerve. Methods. A 16-year-old boy with thoracic scoliosis had normal posterior tibial nerve somatosensory-evoked potentials both before surgery and in the operating room immediately after anesthesia induction and prone positioning on a four-post Spinal Frame. Results. One hour after the start of surgery, a minimal amplitude reduction of the right popliteal fossa potentials appeared. Fifteen minutes later, the amplitudes of the popliteal fossa, subcortical, and cortical potentials evoked by right posterior tibial nerve stimulation became substantially reduced. Subsequently, all waveforms were lost. Malfunction of the right posterior tibial nerve stimulator was initially suspected, but when proper function was verified, a search for other causes of this loss led to discovery of leg ischemia. The patient was repositioned on the Spinal Frame, and all posterior tibial nerve somatosensory-evoked potentials waveforms began to reappear 7 minutes later. There was no postoperative clinically detectable complication. Conclusions. Although technical malfunction should always be suspected when all intraoperative somatosensory-evoked potential waveforms are initially seen and subsequently lost, one should also consider the possibility that intraoperative ischemia due to limb positioning could be the etiology.
John P Dormans - One of the best experts on this subject based on the ideXlab platform.
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prevention of positional brachial plexopathy during surgical correction of scoliosis
Journal of Spinal Disorders, 2000Co-Authors: Daniel M Schwartz, Denis S Drummond, Miah Hahn, Malcolm L Ecker, John P DormansAbstract:Continuous intraoperative monitoring of Spinal cord function using somatosensory evoked potentials (SSEP) has gained nearly universal acceptance as a reliable and sensitive method for detecting and possibly preventing neurologic injury during surgical correction of Spinal deformities. In several reports, Spinal cord injury was identified successfully based on changes in SSEP response characteristics, specifically amplitude and latency. Less well documented and used, however, is monitoring of peripheral nerve function with SSEPs to identify and prevent the neurologic sequelae of prolonged prone positioning on a Spinal Frame. The authors describe a patient who underwent surgical removal of Spinal instrumentation but was not monitored. A brachial plexopathy developed in this patient from pressure on the axilla exerted by a Relton-Hall positioning Frame during Spinal surgery. In addition, data are presented from 15 of 500 consecutive pediatric patients who underwent surgical correction of scoliosis between 1993 and 1997 with whom intermittent monitoring of ulnar nerve SSEPs was used successfully to identify impending brachial plexopathy, a complication of prone positioning. A statistically significant reduction in ulnar nerve SSEP amplitude was observed in 18 limbs of the 500 patients (3.6%) reviewed. Repositioning the arm(s) or shoulders resulted in nearly immediate improvement of SSEP amplitude, and all awoke without signs of brachial plexopathy. This complication can be avoided by monitoring SSEPs to ulnar nerve stimulation for patients placed in the prone position during Spinal surgery.
Daniel M Schwartz - One of the best experts on this subject based on the ideXlab platform.
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prevention of positional brachial plexopathy during surgical correction of scoliosis
Journal of Spinal Disorders, 2000Co-Authors: Daniel M Schwartz, Denis S Drummond, Miah Hahn, Malcolm L Ecker, John P DormansAbstract:Continuous intraoperative monitoring of Spinal cord function using somatosensory evoked potentials (SSEP) has gained nearly universal acceptance as a reliable and sensitive method for detecting and possibly preventing neurologic injury during surgical correction of Spinal deformities. In several reports, Spinal cord injury was identified successfully based on changes in SSEP response characteristics, specifically amplitude and latency. Less well documented and used, however, is monitoring of peripheral nerve function with SSEPs to identify and prevent the neurologic sequelae of prolonged prone positioning on a Spinal Frame. The authors describe a patient who underwent surgical removal of Spinal instrumentation but was not monitored. A brachial plexopathy developed in this patient from pressure on the axilla exerted by a Relton-Hall positioning Frame during Spinal surgery. In addition, data are presented from 15 of 500 consecutive pediatric patients who underwent surgical correction of scoliosis between 1993 and 1997 with whom intermittent monitoring of ulnar nerve SSEPs was used successfully to identify impending brachial plexopathy, a complication of prone positioning. A statistically significant reduction in ulnar nerve SSEP amplitude was observed in 18 limbs of the 500 patients (3.6%) reviewed. Repositioning the arm(s) or shoulders resulted in nearly immediate improvement of SSEP amplitude, and all awoke without signs of brachial plexopathy. This complication can be avoided by monitoring SSEPs to ulnar nerve stimulation for patients placed in the prone position during Spinal surgery.