دورية أكاديمية
أعرض في EDS

Intraoperative Neurological Monitoring in Lower Limb Surgery for Patients With Mucopolysaccharidoses.

التفاصيل البيبلوغرافية
العنوان: Intraoperative Neurological Monitoring in Lower Limb Surgery for Patients With Mucopolysaccharidoses.
المؤلفون: Georgiadis AG; Gillette Children's Specialty Healthcare, Saint Paul.; Department of Orthopaedic Surgery., Koester TM; Gillette Children's Specialty Healthcare, Saint Paul., Mackenzie WG; Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE., Nahm NJ; Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE., Novotny SA; Gillette Children's Specialty Healthcare, Saint Paul.; Rehabilitation Science Graduate Program, University of Minnesota, Minneapolis, MN., Rogers KJ; Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE., Siljander BR; Gillette Children's Specialty Healthcare, Saint Paul.; Department of Orthopaedic Surgery., Sousa TC; Department of Orthopaedic Surgery, Seattle Children's, Seattle.; Department of Orthopaedic Surgery, Shriner's Hospital for Children, Spokane, WA., White KK; Department of Orthopaedic Surgery, Seattle Children's, Seattle., Walker KR; Gillette Children's Specialty Healthcare, Saint Paul.; Department of Orthopaedic Surgery.
المصدر: Journal of pediatric orthopedics [J Pediatr Orthop] 2021 Mar 01; Vol. 41 (3), pp. 182-189.
نوع المنشور: Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8109053 Publication Model: Print Cited Medium: Internet ISSN: 1539-2570 (Electronic) Linking ISSN: 02716798 NLM ISO Abbreviation: J Pediatr Orthop Subsets: MEDLINE
أسماء مطبوعة: Publication: 2000- : Philadelphia : Lippincott Williams & Wilkins
Original Publication: New York Ny : Raven Press
مواضيع طبية MeSH: Intraoperative Neurophysiological Monitoring/*statistics & numerical data , Lower Extremity/*surgery , Mucopolysaccharidoses/*surgery , Orthopedic Procedures/*adverse effects , Spinal Cord Injuries/*etiology, Child ; Female ; Humans ; Male ; Orthopedic Procedures/statistics & numerical data ; Retrospective Studies ; Trauma, Nervous System
مستخلص: Background: There are reports of spinal cord injury (SCI) occurring after lower extremity (LE) surgery in children with mucopolysaccharidoses (MPS). Intraoperative neurological monitoring (IONM) has been adopted in some centers to assess real-time spinal cord function during these procedures. The aim of this investigation was to review 3 specialty centers' experiences with MPS patients undergoing LE surgery. We report how IONM affected care and the details of spinal cord injuries in these patients.
Methods: All pediatric MPS patients who underwent LE surgery between 2001 and 2018 were reviewed at 3 children's orthopaedic specialty centers. Demographic and surgical details were reviewed. Estimated blood loss (EBL), surgical time, positioning, use of IONM, and changes in management as a result of IONM were recorded. Details of any spinal cord injuries were examined in detail.
Results: During the study period, 92 patients with MPS underwent 252 LE surgeries. IONM was used in 83 of 252 (32.9%) surgeries, and intraoperative care was altered in 17 of 83 (20.5%) cases, including serial repositioning (n=7), aggressive blood pressure management (n=6), and abortion of procedures (n=8). IONM was utilized in cases with larger EBL (279 vs. 130 mL) and longer operative time (274 vs. 175 min) compared with procedures without IONM. Three patients without IONM sustained complete thoracic SCI postoperatively, all from cord infarction in the upper thoracic region. These 3 cases were characterized by long surgical time (328±41 min) and substantial EBL (533±416 mL or 30.5% of total blood volume; range, 11% to 50%). No LE surgeries accompanied by IONM experienced SCI.
Conclusions: Patients with MPS undergoing LE orthopaedic surgery may be at risk for SCI, particularly if the procedures are long or are expected to have large EBL. One hypothesis for the etiology of SCI in this setting is hypoperfusion of the upper thoracic spinal cord due to prolonged intraoperative or postoperative hypotension. IONM during these procedures may mitigate the risk of SCI by identifying real-time changes in spinal cord function during surgery, inciting a change in the surgical plan.
Level of Evidence: Level III-retrospective comparative series.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
References: Williams N, Challoumas D, Eastwood DM. Does orthopaedic surgery improve quality of life and function in patients with mucopolysaccharidoses? J Child Orthop. 2017;11:289–297.
White KK, Jester A, Bache CE, et al. Orthopedic management of the extremities in patients with Morquio A syndrome. J Child Orthop. 2014;8:295–304.
Kanazawa T, Yasunaga Y, Ikuta Y, et al. Femoral head dysplasia in Morquio disease type A: bilateral varus osteotomy of the femur. Acta Orthop Scand. 2001;72:18–21.
Thawrani DP, Walker K, Polgreen LE, et al. Hip dysplasia in patients with Hurler syndrome (mucopolysaccharidosis type 1H). J Pediatr Orthop. 2013;33:635–643.
Lewis JR, Gibson PH. Bilateral hip replacement in three patients with lysosomal storage disease: mucopolysaccharidosis type IV and Mucolipidosis type III. J Bone Joint Surg Br. 2010;92:289–292.
O’Heireamhoin S, Bayer T, Mulhall KJ. Total hip arthroplasty in mucopolysaccharidosis type IH. Case Rep Orthop. 2011;2011:832439.
Linstedt U, Maier C, Joehnk H, et al. Threatening spinal cord compression during anesthesia in a child with mucopolysaccharidosis VI. Anesthesiology. 1994;80:227–229.
Hamilton DK, Smith JS, Sansur CA, et al. Rates of new neurological deficit associated with spine surgery based on 108,419 procedures: a report of the scoliosis research society morbidity and mortality committee. Spine. 2011;36:1218–1228.
Horovitz DD, Magalhaes Tde S, Pena e Costa A, et al. Spinal cord compression in young children with type VI mucopolysaccharidosis. Mol Genet Metab. 2011;104:295–300.
Pizzutillo PD, Osterkamp JA, Scott CI Jr, et al. Atlantoaxial instability in mucopolysaccharidosis type VII. J Pediatr Orthop. 1989;9:76–78.
Tandon V, Williamson JB, Cowie RA, et al. Spinal problems in mucopolysaccharidosis I (Hurler syndrome). J Bone Joint Surg Br. 1996;78:938–944.
Yasin MN, Sacho R, Oxborrow NJ, et al. Thoracolumbar kyphosis in treated mucopolysaccharidosis 1 (Hurler syndrome). Spine. 2014;39:381–387.
Drummond JC, Krane EJ, Tomatsu S, et al. Paraplegia after epidural-general anesthesia in a Morquio patient with moderate thoracic spinal stenosis. Can J Anaesth. 2015;62:45–49.
Pauchard N, Garin C, Jouve JL, et al. Perioperative medullary complications in spinal and extra-spinal surgery in mucopolysaccharidosis: a case series of three patients. Clin JMID Rep. 2014;16:95–99.
Pruszczynski B, Mackenzie WG, Rogers K, et al. Spinal cord injury after extremity surgery in children with thoracic kyphosis. Clin Orthop Relat Res. 2015;473:3315–3320.
Tong CK, Chen JC, Cochrane DD. Spinal cord infarction remote from maximal compression in a patient with Morquio syndrome. J Neurosurg Pediatr. 2012;9:608–612.
Roberts TT, Leonard GR, Cepela DJ. Classifications in brief: American Spinal Injury Association (ASIA) Impairment Scale. Clin Orthop Relat Res. 2017;475:1499–1504.
Linderkamp O, Versmold HT, Riegel KP, et al. Estimation and prediction of blood volume in infants and children. Eur J Pediatr. 1977;125:227–234.
Malm G, Lund AM, Mansson JE, et al. Mucopolysaccharidoses in the Scandinavian countries: incidence and prevalence. Acta Paediatr. 2008;97:1577–1581.
Khan SA, Peracha H, Ballhausen D, et al. Epidemiology of mucopolysaccharidoses. Mol Genet Metab. 2017;121:227–240.
Nelson J, Crowhurst J, Carey B, et al. Incidence of the mucopolysaccharidoses in Western Australia. Am J Med Genet A. 2003;123A:310–313.
Muenzer J. Overview of the mucopolysaccharidoses. Rheumatology (Oxford). 2011;50(suppl 5):v4–v12.
Borgo A, Cossio A, Gallone D, et al. Orthopaedic challenges for mucopolysaccharidoses. Ital J Pediatr. 2018;44:2123.
Link B, de Camargo Pinto LL, Giugliani R, et al. Orthopedic manifestations in patients with mucopolysaccharidosis type II (Hunter syndrome) enrolled in the Hunter Outcome Survey. Orthop Rev. 2010;2:e16.
Kaufman HH, Rosenberg HS, Scott CI, et al. Cervical myelopathy due to dural compression in mucopolysaccharidosis. Surg Neurol. 1982;17:404–410.
Sostrin RD, Hasso AN, Peterson DI, et al. Myelographic features of mucopolysaccharidoses: a new sign. Radiology. 1977;125:421–424.
Reichert R, Campos LG, Vairo F, et al. Neuroimaging findings in patients with mucopolysaccharidosis: what you really need to know. Radiographics. 2016;36:1448–1462.
Schmidt M, Breyer S, Lobel U, et al. Musculoskeletal manifestations in mucopolysaccharidosis type I (Hurler syndrome) following hematopoietic stem cell transplantation. Orphanet J Rare Dis. 2016;11:93.
Attar S, Hankins JR, Turney SZ, et al. Paraplegia after thoracotomy: report of five cases and review of the literature. Ann Thorac Surg. 1995;59:1410–1415; discussion 5-6.
Dogan S, Kocaeli H, Doygun M. Oxidised regenerated cellulose as a cause of paraplegia after thoracotomy: case report and review of the literature. Spinal Cord. 2005;43:445–447.
Shahi N, Asante-Siaw J, Marzouk JFK. Paraplegia following oesophagectomy. BMJ Case Rep. 2010;2010:bcr0920092270.
Charrow J, Alden TD, Breathnach CA, et al. Diagnostic evaluation, monitoring, and perioperative management of spinal cord compression in patients with Morquio syndrome. Mol Genet Metab. 2015;114:11–18.
Kelleher MO, Tan G, Sarjeant R, et al. Predictive value of intraoperative neurophysiological monitoring during cervical spine surgery: a prospective analysis of 1055 consecutive patients. J Neurosurg Spine. 2008;8:215–221.
Nuwer MR, Dawson EG, Carlson LG, et al. Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol. 1995;96:6–11.
Paradiso G, Lee GY, Sarjeant R, et al. Multimodality intraoperative neurophysiologic monitoring findings during surgery for adult tethered cord syndrome: analysis of a series of 44 patients with long-term follow-up. Spine. 2006;31:2095–2102.
Sutter M, Eggspuehler A, Jeszenszky D, et al. The impact and value of uni- and multimodal intraoperative neurophysiological monitoring (IONM) on neurological complications during spine surgery: a prospective study of 2728 patients. Eur Spine J. 2019;28:599–610.
Drake J, Zeller R, Kulkarni AV, et al. Intraoperative neurophysiological monitoring during complex spinal deformity cases in pediatric patients: methodology, utility, prognostication, and outcome. Childs Nerv Syst. 2010;26:523–544.
Kandil AI, Pettit CS, Berry LN, et al. Tertiary pediatric academic institution’s experience with intraoperative neuromonitoring for nonspinal surgery in children with mucopolysaccharidosis, based on a novel evidence-based care algorithm. Anesth Analg. 2020;130:1678–1684.
Ushirozako H, Yoshida G, Hasegawa T, et al. Characteristics of false-positive alerts on transcranial motor evoked potential monitoring during pediatric scoliosis and adult spinal deformity surgery: an “anesthetic fade” phenomenon. J Neurosurg Spine. 2019;22:1–9.
تواريخ الأحداث: Date Created: 20201216 Date Completed: 20210506 Latest Revision: 20210506
رمز التحديث: 20240628
DOI: 10.1097/BPO.0000000000001720
PMID: 33323879
قاعدة البيانات: MEDLINE
الوصف
تدمد:1539-2570
DOI:10.1097/BPO.0000000000001720