Electrophysiologic monitoring during surgery to repair the thoraco-abdominal aorta.
Prevention of paraplegia during the repair of thoraco-abdominal aortic aneurysms and dissections present a substantial challenge to the operative team. The value of intraoperative electrophysiological monitoring (IOM) is to identify spinal cord ischemia that occurs during the procedure and guide the intraoperative management to reduce the risks of paralysis. The usefulness of IOM techniques requires an understanding of spinal cord blood flow and the spinal cord physiology, the surgical technique and their interaction. This paper will integrate these factors to review the laboratory and clinical experience with somatosensory evoked responses (SSEP) and motor evoked potentials (MEP) during thoraco-abdominal aorta surgery.
Sloan
Tod B
TB
Department of Anesthesiology, University of Colorado at Denver and Health Sciences Center, Denver, Colorado 80262, USA. Tod.Sloan@uchsc.edu
Jameson
Leslie C
LC
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D004594:Electrophysiology; D019054:Evoked Potentials, Motor / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D006801:Humans; D007431:Intraoperative Complications; D016343:Monitoring, Intraoperative / Q000379:methods*; D010264:Paraplegia / Q000209:etiology / Q000517:prevention & control; D013116:Spinal Cord / Q000098:blood supply / Q000601:surgery; D013903:Thoracic Surgery / Q000379:methods