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Correlation of Clinical Outcome with Intraoperative Neuro-monitoring of Spinal Tumours of Thoracic Region: Our Experience

responding Author: Shivani Rastogi, Associate Professor, Department of Anesthesia, RML Institute of Medical Sciences, Lucknow, Uttar Pradesh 226010, India. , Shivani Rastogi , Dharmendra Kumar Srivastava , Depak Kumar Singh , Dinkar Kulshreshtha , Bhuwan Chandra Tiwari , Namrata Punit Awasthi ,

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Journal of Cardiovascular Medicine and Surgery 4(2):p 133-136, April-June 2018. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4218.11

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Abstract

Introduction: The goal of treatment for spinal tumours of thoracic region is complete removal with minimal postoperative neurological deficit.

Methods: According to the extension of spinal tumour we divided patients into two groups­A­spinal tumours only. B­ Spinal tumours with neuroforaminal and mediastinal extension. We reviewed clinical outcome with intraoperative neuro­monitoring of spinal tumours of thoracic region from 2012 to 2016.

Results: Forty three patients were analyzed (group A and B­ 93% and 6.97% cases respectively). In both groups spinal tumours were common in male (67.5% and 66.6% in group A & B respectively). Intraoperative neuromonitoring used in all cases and help in complete removal of tumour. The posterior midline approach of surgery were used in all cases (100%) in group A while in group B anterior (thoracotomy) and combined approach in 33.3% cases each. We find that the complete neurological recovery in 97.5% in group A and 100% in group B.

Conclusions: Hinojosa et al. find that neuro­monitoring may help to minimize postoperative motor deficit by avoiding or correcting spinal cord tumour manipulation and modifying surgical technique during tumour resection. We concluded that the correlation of changes in transcranial motor evoked potential and electromyography on corresponding muscles help in nerve root identification and complete removal of spinal tumours without any postoperative neurological deficit. Spinal tumours having extension to neurofoamina/mediastinal are very rare and their complete removal needs correct preoperative diagnosis and single or two stage surgical approach.


 

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4218.11

Keywords

Neuromonitoring; Mediastinum; Tumour; Thoracotomy; Nerve Root.

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