The Influence of Monitoring Somatosensory and Motor Evoked Potentials on the Complication Rate During CNS Surgery
Elvira Lisovskaja, Kristina Kairytė, Saulius Ročka
Introduction. With the improvement of medical technology, surgical intervention is more often applied as a treatment of the disorders of the central nervous system. Neurosurgery, however, is associated with the higher risk of post-surgery complications. To reduce the risk, electrophysiological monitoring is often employed during the surgery. The monitoring allows immediate evaluation of the functional integrity of the nervous sys tem.
The aim of the study was to evaluate the efficacy of the monitoring of motor and somatosensory evoked potentials on the complication rate after spinal cord and brain surgery.
Materials and methods. The study comprises the analysis of 365 spinal cord and brain neurosurgeries, performed in the period 2006 to 2009 at Vilnius Uni - versity Emergency Hospital.
Three hundred and forty five patients underwent a standard operation (the control group), and 20 patients had their motor and somatosensory evoked potentials monitored during the surgery (the experimental group). Facial motor and sensory function of the patients from both groups was evaluated before and after surgery, and the post-surgery complication rate was compared between the two groups.
Results. During the surgery of the 5th and 8th cranial nerve neurinoma the motor and sensor function of body and limbs as well as face was evaluated.
The results indicated that the rate of facial sensor and motor complications after the surgery of the 5th and 8th cranial nerves, performed with the monitoring of trigeminal and facial cranial nerve, was statistically significantly lower than the complication rate after surgeries performed without monitoring (p=0.048 and p=0.037, respectively). The complication rate of sensor and motor function of the body and limbs after the surgery performed with and without monitoring did not differ significantly (p=0.646 and p=0.68, respectively).
The results showed that sensor and motor complication rate after spinal cord surgeries performed with and without monitoring of evoked potentials did not differ significantly (p=0.647 and p=0.637, respectively).
Conclusions. The monitoring of evoked potentials of trigeminal and facial cranial nerves reduced the facial sensor and motor complication rate after the surgery of the 5th and 8th cranial nerve. The monitoring of evoked potentials did not affect the complication rate of the body and limb sensor and motor function after the surgery of the 5th and 8th cranial nerve. The effect of monitoring of evoked potentials on the sensor and motor complication rate after spinal cord surgeries was not established.
Keywords: intra-surgery monitoring, evoked potentials, complications of CNS surgeries.
