Browse > Article
http://dx.doi.org/10.15324/kjcls.2021.53.2.193

An Effective Transcranial Electric Motor-Evoked Potentials Method in Spinal Dural Arteriovenous Fistula Ligation Surgery  

Jang, Min Hwan (Department of Neurology, Institute of Neuroscience Center, Samsung Medical Center)
Lee, In Seok (Department of Neurology, Institute of Neuroscience Center, Samsung Medical Center)
Lim, Sung Hyuk (Department of Neurology, Institute of Neuroscience Center, Samsung Medical Center)
Publication Information
Korean Journal of Clinical Laboratory Science / v.53, no.2, 2021 , pp. 193-198 More about this Journal
Abstract
The purpose of spinal dural arteriovenous fistula (SDAVF) ligation is to prevent neurological injury and the poor blood supply through ligation of arteriovenous fistula. Therefore, intraoperative neurophysiological monitoring (INM) is required via multimodal neurological examination for minimizing the side effects after surgery based on the patient's symptoms. Transcranial electric motor-evoked potentials (TceMEP) help to check the condition of the corticospinal tract. Whenever ligation is performed, TceMEP should be performed every minute to check for abnormalities. However, an examiner's lack of knowledge about the operation procedure and examination and also poor communication between the examiner and surgeon can cause incorrect timing of the stimulation of TceMEP that interferes with the procedure and causes side effects such as paralysis and motor weakness. As a result of this SDAVF ligation survey, it is believed that for proper INM, case reports will be needed along with further research and the examiner will also have to work closely with the surgeon to minimize neurological damage to patients.
Keywords
INM; Neurosurgery; SDAVF; TceMEP;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Gopalakrishna KN, Menon P, Singh P, Pruthi N, Bharadwaj S. Multimodal intraoperative monitoring during microsurgical treatment of spinal dural arteriovenous fistula. Turk J Anaesthesiol Reanim. 2020;48:423-426. https://doi.org/10.5152/TJAR.2020.88942   DOI
2 Chul HK, Young SP, Hong KS, Chul HS. Myelopathy due to spinal dural arteriovenous fistula: a case report. J Korean Soc Spine Surg. 2006;13:126-131. https://doi.org/10.4184/jkss.2006.13.2.126   DOI
3 Chung SK, Jeon SR, Chung CK, Kim HJ. Surgical treatment of arteriovenous malformation of the spinal cord. J Korean Neurosurg Soc. 1997;26:1592-1598.
4 Ghadirpour R, Nasi D, Iaccarino C, Romano A, Motti L, Farneti M, et al. Intraoperative neurophysiological monitoring in surgical treatment of spinal dural arteriovenous fistulas: technique and results. Asian J Neurosurg. 2018;13:595-606. https://doi.org/10.4103/ajns.AJNS_209_16   DOI
5 Kim YS, Park YG, Yi HS, Park JY, Lee JW, Pyo SE, et al. Anterior choroidal artery infarction with no abnormalities of motor evoked potentials during cerebral aneurysm surgery -a case report-. J Korean Assoc Electrodiagn Med. 2017;19:76-82. https://doi.org/10.18214/ikaem.2017.19.2.76   DOI
6 Sohn MJ, Park HC, Park HS, Kim JJ, Kim EY. Surgical treatment of intradural perimedullary arteriovenous fistula(type IV spinal cord arteriovenous malformation). J Korean Neurosurg Soc. 2002;31: 384-387.
7 Neuloh G, Schramm J. Monitoring of motor evoked potential compared with somatosensory evoked potentials and microvascular doppler ultrasonography in cerebral aneurysm surgery. J Neurosurg 2004;100:389-399. https://doi.org/10.3171/jns.2004.100.3.0389   DOI
8 Kim SY, Kim JS, Park KS. Utility of intraoperative bulbocavernosus reflex monitoring for post-operative bladder function in surgical correction of conus medullaris arteriovenous fistula: case report. J Intraoper Neurophysiol. 2020;2:98-102. https://doi.org/10.33523/join.2020.2.2.98   DOI