title: Safe transcranial electric stimulation motor evoked potential monitoring during posterior spinal fusion in two patients with cochlear implants.
abstract: Transcranial electric stimulation (TES) motor evoked potentials (MEPs) have become a regular part of intraoperative neurophysiologic monitoring (IONM) for posterior spinal fusion (PSF) surgery. Almost all of the relative contraindications to TES have come and gone. One exception is in the case of patients with a cochlear implant (CI). Herein we illustrate two cases of pediatric patients with CIs who underwent PSF using TES MEPs as part of IONM. In both instances the patients displayed no untoward effects from TES, and post-operatively both CIs were intact and functioning as they were prior to surgery.
authors.affiliation: Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd., Richard D. Wood Ambulatory Care Building, Second Floor, Philadelphia, PA, 19104, USA.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Yellin
authors.affiliation: Specialty Care (Intraoperative Neurophysiologic Monitoring), One American Center, 3100 West End Avenue, Suite 800, Nashville, TN, 37203, USA.
authors.forename: Cheryl R
authors.initials: CR
authors.lastname: Wiggins
authors.affiliation: Specialty Care (Intraoperative Neurophysiologic Monitoring), One American Center, 3100 West End Avenue, Suite 800, Nashville, TN, 37203, USA.
authors.forename: Alier J
authors.initials: AJ
authors.lastname: Franco
authors.affiliation: Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd., Richard D. Wood Ambulatory Care Building, Second Floor, Philadelphia, PA, 19104, USA. Sankarw@email.chop.edu.
authors.forename: Wudbhav N
authors.initials: WN
authors.lastname: Sankar
mesh_terms: D000293:Adolescent; D002648:Child; D003054:Cochlear Implants; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D012600:Scoliosis / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D065908:Transcranial Direct Current Stimulation
keywords: Cochlear implant; Intraoperative neurophysiologic monitoring; Motor evoked potentials; Neuromonitoring; Pediatrics; Posterior spinal fusion; Somatosensory evoked potentials; Transcranial electric stimulation