The role of intraoperative electromyographic monitoring in lumbosacral lipomas.
OBJECTIVE
To demonstrate the role of intraoperative multichannel electromyographic (EMG) monitoring to reduce postoperative deterioration and achieve full untethering of complex occult dysraphisms.


METHODS
A retrospective analysis was performed on 66 patients who underwent operation for lumbosacral lipomas. Twenty recent cases were submitted to EMG monitoring and stimulation.


RESULTS
All patients presented symptoms at the time of surgery, and 74% exhibited progressive deterioration during the lengthy preoperative period. Postoperative surgery-related deterioration was observed in 6% of patients. This number was reduced to zero with the introduction of intraoperative EMG monitoring.


CONCLUSIONS
Intraoperative multichannel EMG monitoring can be carried out and requires only minimal changes to anesthetic procedures. With this method, it is possible to better identify the neural structures of complex malformations, reducing the risks of surgical damage and incomplete detethering.
Valentini
Laura Grazia
LG
Department of Neurosurgery, Istituto Nazionale Neurologico Carlo Besta, Milan, Italy. lvalentini@istituto-besta.it
Visintini
Sergio
S
Mendola
Carmela
C
Casali
Cecilia
C
Bono
Renata
R
Scaioli
Widmer
W
Solero
Carlo L
CL
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008067:Lipoma / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009436:Neural Tube Defects / Q000209:etiology; D019635:Neurosurgical Procedures / Q000009:adverse effects; D012189:Retrospective Studies; D012447:Sacrum; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome