PK Upadhyay¹*, G Tiwary², G Luthra³, K Upadhyay⁴ and Kritika U⁴

¹Head of Neurosurgery Department, Institute of Human Behavior and Allied Sciences Hospital, Dilshad Garden, Delhi, India
²Director Laboratory Sciences, House of Diagnostic, Delhi, India
³Physiotherapist - Neurosurgery, IHBAS, Delhi, India ⁴MBBS Fellow (JSSMC and MAMC), India

*Corresponding Author: PK Upadhyay, Head of Neurosurgery Department, Institute of Human Behavior and Allied Sciences Hospital, Dilshad Garden, Delhi, India.

Received: December 20, 2021; Published: January 07, 2022

Abstract

130 cases operated by the senior author in 30 years utilizing neurophysiological monitoring, using lumbosacral discectomy and decompression for canal stenosis and destabilization by immediate fixation using MRI compatible titanium pedicle rods and screw under intraoperative Neurophysiological monitoring of somato sensory evoked potential and motor evoked potential, which helped immensely in preventing damage to neural structure and decreasing the chances of mortality and morbidity for patients and confidence and reliable method for neuro-spinal surgeon.

Keywords: Lombo Sacral; Pedicle Screws and Rods; MRI Compatible; Titanium Screw and Rods; Intraoperative Neurophysiological Monitoring; SSEP, MEP; SEP;

References

1. Steffee AD. “The variable srew placement system with posterior lumbar interbody fusion”. In LIN PM, Gill K (Eds). Lumber inter body fusion Principles and Techniques in Spine Surgery. Aspen publisher INc. 81 (1989).
2. Steffee AD., et al. “Segmental spines with pedicle srew fixation. A new internal fixation device for disorders of the lumbar and thoracolumbar spine”. Clinical Orthopaedics and Related Research 203 (1986): 45.
3. Schneck CD. “The anatomical determinants of lumbar spondylosis”. In Ramani PS (Ed).Posterior lumbar inter body fusion”. Associated Personnel Services Publication 11 (1989).
4. Nuwer MR., et al. “Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey”. Electroencephalography and Clinical Neurophysiology 96 (1995): 6-11.
5. Nuwer MR. “Spinal cord monitoring”. Muscle Nerve 22 (1999): 1620-1630.
6. Macdonald DB., et al. “Intraoperative motor evoked potential monitoring - a position statement by the American Society of Neurophysiological Monitoring”. Clinical Neurophysiology 124 (2013): 2291-2316.
7. Kothbauer KF. “Intraoperative neurophysiologic monitoring for intramedullary spinal-cord tumor surgery”. Neurophysiology Clinics 37 (2007): 407-414.
8. Owen JH., et al. “Sensitivity and specificity of somatosensory and neurogenic-motor evoked potentials in animals and humans”. Spine (Phila Pa 1976) 13 (1988): 1111-1118.
9. Morota N., et al. “The role of motor evoked potentials during surgery for intramedullary spinal cord tumors”. Neurosurgery6 (1997): 1327-1336.
10. Kothbauer KF., et al. “Motor-evoked potential monitoring for intramedullary spinal cord tumor surgery: correlation of clinical and neurophysiological data in a series of 100 consecutive procedures”. Neurosurgery Focus 4 (1998): e1.
11. Ulkatan S., et al. “Monitoring of scoliosis surgery with epidurally recorded motor evoked potentials (D wave) revealed false results”. Clinical Neurophysiology 117 (2006): 2093-2101.
12. Deiner S. “Highlights of anesthetic considerations for intraoperative neuromonitoring”. Seminars in Cardiothoracic and Vascular Anesthesia 14 (2010): 51-53.
13. Lall RR., et al. “Intraoperative neurophysiological monitoring in spine surgery: indications, efficacy, and role of the preoperative checklist”. Neurosurgery Focus 33 (2012): E10.
14. Gonzalez AA., et al. “Intraoperative neurophysiological monitoring during spine surgery: a review”. Neurosurgery Focus 27 (2009): E6.
15. Calancie B., et al. “Intraoperative evoked EMG monitoring in an animal model. A new technique for evaluating pedicle screw placement”. Spine (Phila Pa 1976) 17 (1992): 1229-1235.
16. Bosnjak R and Dolenc VV. “Electrical thresholds for biomechanical response in the ankle to direct stimulation of spinal roots L4, L5, and S1. Implications for intraoperative pedicle screw testing”. Spine (Phila Pa 1976) 25 (2000): 703-708.
17. Tamaki T and Kubota S. “History of the development of intraoperative spinal cord monitoring”. European Spine Journal 16 (2007): S140-S146.
18. Jong-Hwa Park and Seung-Jae Hyun. “Intraoperative neurophysiological monitoring in spinal surgery”. World Journal of Clinical Cases 9 (2015): 765-773.
19. Yuguang Chena Baoqing P., et al. “Neurophysiological monitoring of lumbar spinal nerve roots: A case report of postoperative deficit and literature review”. International Journal of Surgery Case Reports 30 (2017): 218-221.

Citation

Citation: PK Upadhyay., et al. “Lumbo Sacral Fixation After Lumbosacral Decompression for Disc and Spondilotic Changes Along with Instability and Stabilization with MRI Compatible Titanium Pedical Screw and Rods Fixation Under Neurophysiological Monitoring to Reduce Morbidity and Complication, An Experience of 30 Years”.Acta Scientific Medical Sciences 6.2 (2022): 11-17.

Copyright

Copyright: © 2022 PK Upadhyay., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.