title: Concomitant hypertension, bradycardia, and loss of transcranial electric motor evoked potentials during pedicle hook removal: report of a case.
abstract: Neurophysiologic monitors in the form of transcranial electric motor evoked potentials (tceMEPs) and somatosensory evoked potentials (SSEPs) have become widely used modalities to monitor spinal cord function during major orthopedic spine procedures. In combination with invasive and non-invasive clinical monitoring and an anesthesia information management system (AIMS), we promptly recognized an acute change in hemodynamic and neurophysiologic parameters, managed intraoperative spinal cord contusion, and successfully minimized iatrogenic injury to the spinal cord during corrective spine surgery.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. ambardekara@email.chop.edu
authors.forename: A P
authors.initials: AP
authors.lastname: Ambardekar
authors.forename: A K
authors.initials: AK
authors.lastname: Sestokas
authors.forename: D M
authors.initials: DM
authors.lastname: Schwartz
authors.forename: J M
authors.initials: JM
authors.lastname: Flynn
authors.forename: M
authors.initials: M
authors.lastname: Rehman
mesh_terms: D000293:Adolescent; D001919:Bradycardia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D020878:Device Removal / Q000009:adverse effects*; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation; D050781:Transcranial Magnetic Stimulation / Q000379:methods*