Loss of intraoperative neurological monitoring signals during flexed prone positioning on a hinged open frame during surgery for kyphoscoliosis correction: Case report

Randall B. Graham*, Mathew Cotton, Antoun Koht, Tyler R. Koski

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Various complications of prone positioning in spine surgery have been described in the literature. Patients in the prone position for extended periods are subject to neurological deficits and/or loss of intraoperative signals due to compression neuropathies, but positioning-related spinal deficits are rare in the thoracolumbar deformity population. The authors present a case of severe kyphoscoliotic deformity with critical thoracolumbar stenosis in which, during the use of a hinged open frame in the prone position, complete loss of intraoperative neural monitoring signals occurred while the frame was flexed into kyphosis to facilitate exposure and instrumentation placement. When the frame was reset to a neutral position, evoked potentials returned to baseline and the operation proceeded without complications. This case represents, to the authors’ knowledge, the first report of loss of evoked potentials due to an alteration of prone positioning on a hinged open frame. When positioning patients in such a manner, careful attention should be directed to intraoperative signals in patients with critical stenosis and kyphotic deformity.

Original languageEnglish (US)
Pages (from-to)339-343
Number of pages5
JournalJournal of Neurosurgery: Spine
Volume29
Issue number3
DOIs
StatePublished - Sep 2018

Keywords

  • Adult spinal deformity
  • Complications
  • Evoked potentials
  • Positioning
  • Surgical technique
  • intraoperative neurological monitoring

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Loss of intraoperative neurological monitoring signals during flexed prone positioning on a hinged open frame during surgery for kyphoscoliosis correction: Case report'. Together they form a unique fingerprint.

Cite this