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Intraoperatives Neuromonitoring in der rekonstruktiven Halswirbelsäulenchirurgie

Intraoperative neuromonitoring in cervical deformity surgery

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Zusammenfassung

Die Korrektur von Halswirbelsäulendeformitäten ist mit einem nicht unerheblichen Risiko der neurologischen Verschlechterung verbunden. Ein intraoperatives Neuromonitoring (IOM) kann die Patientensicherheit in diesem Zusammenhang deutlich erhöhen. Allerdings ist die Datenlage bezüglich der Wirksamkeit in der rekonstruktiven HWS-Chirurgie beschränkt. Da das chirurgische Manöver in der rekonstruktiven HWS-Chirurgie mit den gleichen Risiken für das Rückenmark einhergeht wie die Skoliosekorrektur, ist von einem vergleichbaren Einfluss des IOM auf das klinische Ergebnis auszugehen. Für das IOM ist eine Senkung der Rate neurologischer Komplikationen im Rahmen der Skoliosechirurgie belegt. Im vorliegenden Beitrag wird die aktuelle Studienlage zur Wirksamkeit des IOM in der rekonstruktiven HWS-Chirurgie sowie in der Skoliosechirurgie erörtert.

Abstract

Correction of cervical deformity is associated with a considerable risk of neurological deterioration. The use of intraoperative neuromonitoring (IOM) can, however, significantly increase patient safety. Nonetheless, data on the effectiveness of IOM during reconstructive cervical surgery are very limited. Since the surgical maneuvers in reconstructive cervical surgery represent the same dangers to the spinal cord as in scoliosis correction, the same influence of IOM on the clinical outcome may be assumed. IOM has been shown to decrease the rate of neurological complications in scoliosis surgery. Herein, we discuss the current evidence for the efficacy of IOM during reconstructive cervical surgery as well as during scoliosis surgery.

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Abbreviations

EEG:

Elektroenzephalogram

HWS:

Halswirbelsäule

IOM:

Intraoperatives Neuromonitoring

KI:

Konfidenzintervall

MEP:

Motorisch evozierte Potenziale

SSEP:

Somatosensorisch evozierte Potenziale

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Authors and Affiliations

  1. Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München (TUM), Ismaninger Str. 22, 81675, München, Deutschland

    E. Shiban & B. Meyer

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  1. E. Shiban
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Correspondence to E. Shiban.

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Interessenkonflikt

E. Shiban und B. Meyer geben an, dass keine Interessenkonflikte bestehen.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Shiban, E., Meyer, B. Intraoperatives Neuromonitoring in der rekonstruktiven Halswirbelsäulenchirurgie. Orthopäde 47, 526–529 (2018). https://doi.org/10.1007/s00132-018-3567-y

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  • DOI: https://doi.org/10.1007/s00132-018-3567-y

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