title: [Intraoperative neurophysiological monitoring in children undergoing tethered cord surgery].
abstract: OBJECTIVE
  To retrospectively explore the multimodal intraoperative monitoring (IOM) technique during untethering cord procedures in 37 patients between 1 month and 16 years of age with tethered cord syndrome during 2014.
  
  
  METHODS
  All patients were diagnosed as tethered cord syndrome by clinical manifestations and verified by magnetic resonance imaging (MRI). Free and trigger electromyogram (EMG) and transcranial motor-evoked potentials (tcMEP) of extremity muscles and anal sphincters were used to map the nerves and monitor the functional motor integrity continuously.
  
  
  RESULTS
  The monitorability rate was 100 % for nervous mapping, 86.5% (32/37) for extremity muscle tcMEP. In all patients, tcMEP remained stable during surgery, 43.8% (14/32) patients showed a significant postoperative increase of amplitude of tcMEP, none of them patients presented a significant and yet transient neurological worsening.
  
  
  CONCLUSIONS
  The combined technique of monitoring and mapping may boost the procedural safety, minimize the long-term morbidity and improve the clinical outcomes.
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Fang
authors.forename: Wenjing
authors.initials: W
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: Lan
authors.affiliation: Email: jvyan@sina.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ju
mesh_terms: D000293:Adolescent; D001003:Anal Canal; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D019054:Evoked Potentials, Motor; D006801:Humans; D007223:Infant; D064795:Intraoperative Neurophysiological Monitoring; D008279:Magnetic Resonance Imaging; D009132:Muscles; D009436:Neural Tube Defects; D019635:Neurosurgical Procedures; D011184:Postoperative Period; D012189:Retrospective Studies