title: Motor evoked potentials in 43 high risk spine deformities.
abstract: BACKGROUND
  Correction of pediatric spine deformities is challenging surgical procedures. This fragile group of patients has many risk factors, therefore prevention of most fearing complication-paraplegia is extremely important. Monitoring of transmission of neurophysiological impulses through motor and sensor pathways of spinal cord gives us an insight into cord's function, and predicts postoperative neurological status.
  
  
  OBJECTIVE
  Aim of this work is to present our experiences in monitoring of spinal cord motor function - MEP during surgical corrections of the hardest pediatric spine deformities, pointing on the most dangerous aspects.
  
  
  METHODS
  We analyzed incidence of MEP changes and postoperative neurological status in patients who had major spine correcting surgery in period April '11- April '14 on our Spine department.
  
  
  RESULTS
  Two of 43 patients or 4.6% in our group experienced significant MEP changes during their major spine reconstructive surgeries. We promptly reduced distractive forces, and MEP normalized, and there were no neurological deficit. Neuromonitoring is reliable method which allows us to "catch" early signs of neurological deficits, when they are still in reversible phase. Although IONM cannot provide complete protection of neurological deficit (it reduces risk of paraplegia about 75%), it at least afford a comfort to the surgeon being fear free that his patient is neurologically intact during long lasting procedures.
authors.affiliation: Department of Orthopedics and Traumatology, Clinical Center, University of Sarajevo, Bosnia and Herzegovina.
authors.forename: Mirza
authors.initials: M
authors.lastname: Biscevic
authors.affiliation: Department for nuclear medicine, General hospital "Prim. Dr Abdulah Nakaš" Sarajevo, Bosnia and Herzegovina.
authors.forename: Sejla
authors.initials: S
authors.lastname: Biscevic
authors.affiliation: Medical faculty, University of Tuzla, Bosnia and Herzegovina.
authors.forename: Farid
authors.initials: F
authors.lastname: Ljuca
authors.affiliation: Department of Neurosurgery, Clinical Center Ljubljana, Slovenia.
authors.forename: Barbara Ur
authors.initials: BU
authors.lastname: Smrke
authors.affiliation: Istanbul Spine Center, Florence Nightingale Hospital, Turkey.
authors.forename: Cagatay
authors.initials: C
authors.lastname: Ozturk
authors.affiliation: Department of neurology, Clinical center University of Sarajevo, Bosnia and Herzegovina.
authors.forename: Merita
authors.initials: M
authors.lastname: Tiric-Campara
mesh_terms: D000293:Adolescent; D000328:Adult; D004784:Environmental Monitoring / Q000379:methods*; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D013116:Spinal Cord / Q000502:physiology*; D013122:Spinal Diseases / Q000601:surgery*; D055815:Young Adult
keywords: deformity; monitoring; neglected; neurological deficit; spine