A case of difficulty predicting neurological deficit during thoracoabdominal aortic surgery.
Perioperative spinal cord injury associated with thoracoabdominal aorta (TAAA) surgery is a devastating complication. With variable results, the intraoperative use of neurophysiologic monitoring has been employed for the diagnosis and prevention of spinal cord ischemia. We present a case report of a patient undergoing TAAA surgery with the use of evoked potential monitoring. Intraoperatively, both sensory and motor evoked potentials were utilized and consequently the patient experienced changes in monitoring consistent with a new neurologic deficit. However, postoperatively these changes in evoked potentials never manifested in neurologic injury. We examine the utility of neurophysiologic monitoring as it pertains to TAAA surgery.
Leff
Jonathan D
JD
Department of Anesthesiology, Montefiore Medical Center, Bronx, NY 10467, USA. jleff@montefiore.org
Sudheera
K S
KS
Shore-Lesserson
Linda
L
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D020760:Spinal Cord Ischemia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods