کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4073769 1266990 2014 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
2014 Neer Award Paper: Neuromonitoring the Latarjet procedure
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
پیش نمایش صفحه اول مقاله
2014 Neer Award Paper: Neuromonitoring the Latarjet procedure
چکیده انگلیسی

BackgroundWe used intraoperative neuromonitoring to define the stages of the Latarjet procedure during which the nerves are at greatest risk.MethodsThirty-four patients with a mean age of 28.4 years were included. The Latarjet procedure was divided into 9 defined stages. Bilateral median and ulnar somatosensory evoked responses and transcranial motor evoked potentials from all arm myotomes were continuously monitored. A “nerve alert” was defined as averaged 50% amplitude attenuation or 10% latency prolongation of ipsilateral somatosensory evoked responses and transcranial motor evoked potentials. For each nerve alert, the surgeon altered retractor placement, and if there was no response to this, the position of the operative extremity was then changed.ResultsOf 34 patients, 26 (76.5%) had 45 separate nerve alert episodes. The most common stages of the procedure for a nerve alert to occur were glenoid exposure and graft insertion. The axillary nerve was involved in 35 alerts; the musculocutaneous nerve, in 22. Of the 34 patients, 7 (20.6%) had a clinically detectable nerve deficit postoperatively, all correlated with an intraoperative nerve alert. All cases involved the axillary nerve, and all resolved completely from 28 to 165 days postoperatively. Prior surgery and body mass index were not predictive of a neurologic deficit postoperatively. However, total operative time (P = .042) and duration of the stage of the procedure in which the concordant nerve alert occurred (P = .010) were statistically significant predictors of a postoperative nerve deficit.ConclusionsThe nerves, in particular the axillary and musculocutaneous nerves, are at risk during the Latarjet procedure, especially during glenoid exposure and graft insertion.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Shoulder and Elbow Surgery - Volume 23, Issue 10, October 2014, Pages 1473–1480
نویسندگان
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