Intraoperative neurophysiological monitoring of somatosensory evoked potentials during hip arthroscopy surgery. 2012

Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
Oregon Health Sciences University, Clinical Neurophysiology, Portland, Oregon, USA. ochsb@ohsu.edu

Arthroscopic hip surgery is used to treat many of the causes of hip pain, hip instability, and hip disorders. Hip pain and instability are often caused by injuries to the acetabular labrum. Repairing labral tears, suturing, and debridement involve stabilizing the hip and placing the operative side leg in traction (Phillipon 2006, Phillipon and Schenker 2006) to allow for instrument clearance and to avoid iatrogenic injury to the chondral surfaces. This places the sciatic nerve in a stretched position and may cause temporary or permanent nerve injury. Transient neuropraxia is the most common injury occurring in 5% of the patients undergoing arthroscopic hip surgery (McCarthy and Lee 2006). 35 patients; 24 women and 11 men, (a total of 36 surgeries) were monitored with intraoperative neurophysiological monitoring using somatosensory evoked potentials (SSEPs) during hip arthroscopy for labral repair and femoral head osteoplasty. They ranged in age from 15 to 59 years; mean age: 39.81 years. During surgery 19 (54%) patients experienced significant SSEP waveform changes. Time from placement of traction to loss of signals in those patients experiencing SSEP changes ranged from 7 minutes to 46 minutes. Recovery of SSEP signals ranged from 2 minutes to over 15 minutes when the traction of the leg was released. Surgeries ranged from 2 to 4 hours; mean: 2.78 hours. These findings show that neuromonitoring during hip arthroscopic labral repair and debridement procedures might be useful to prevent temporary and permanent neural tissue injuries.

UI MeSH Term Description Entries
D007049 Iatrogenic Disease Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment. Hospital-Acquired Condition,Condition, Hospital-Acquired,Conditions, Hospital-Acquired,Disease, Iatrogenic,Diseases, Iatrogenic,Hospital Acquired Condition,Hospital-Acquired Conditions,Iatrogenic Diseases
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D004558 Electric Stimulation Use of electric potential or currents to elicit biological responses. Stimulation, Electric,Electrical Stimulation,Electric Stimulations,Electrical Stimulations,Stimulation, Electrical,Stimulations, Electric,Stimulations, Electrical
D004568 Electrodiagnosis Diagnosis of disease states by recording the spontaneous electrical activity of tissues or organs or by the response to stimulation of electrically excitable tissue. Electrodiagnoses
D005073 Evoked Potentials, Somatosensory The electric response evoked in the CEREBRAL CORTEX by stimulation along AFFERENT PATHWAYS from PERIPHERAL NERVES to CEREBRUM. Somatosensory Evoked Potentials,Evoked Potential, Somatosensory,Somatosensory Evoked Potential
D005260 Female Females
D006621 Hip Joint The joint that is formed by the articulation of the head of FEMUR and the ACETABULUM of the PELVIS. Acetabulofemoral Joint,Acetabulofemoral Joints,Hip Joints,Joint, Acetabulofemoral,Joint, Hip,Joints, Acetabulofemoral,Joints, Hip
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
November 1988, Neurologia medico-chirurgica,
Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
October 1996, Neurosurgery clinics of North America,
Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
February 1986, Boletin de la Asociacion Medica de Puerto Rico,
Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
January 1987, Surgical neurology,
Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
March 1991, Ma zui xue za zhi = Anaesthesiologica Sinica,
Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
June 2005, Journal of clinical monitoring and computing,
Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
October 2021, Journal of clinical monitoring and computing,
Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
January 1991, Anesteziologiia i reanimatologiia,
Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
June 1989, Italian journal of neurological sciences,
Barbara C Ochs, and Andrea Herzka, and Ilker Yaylali
January 1982, Advances in neurology,
Copied contents to your clipboard!