Monitoring monopolaire lors de la chirurgie du rachis avec prothèses costales expansibles

作者: C. Gomes , M. Kuchenbuch , G. Lucas , P. Sauleau , P. Violas

DOI: 10.1016/J.RCOT.2015.03.002

关键词:

摘要: Resume Rappel La reduction du risque neurologique par le monitoring peroperatoire est maintenant bien etablie dans la chirurgie de scoliose. mise en place d’un dispositif vertical expandable prosthetic titanium rib (VEPTR) materiel preservant croissance rachis peut se compliquer lesions moelle epiniere et plexus brachial avec un taux 2 % 5 % patient respectivement. surveillance conjointe ces structures necessite une combinaison methodes longues complexes a mettre œuvre, non adaptees aux exigences pediatrique, particulierement lors des procedures repetees d’elongations. Base sur technique Owen, nous presentons ici stimulation dite « monopolaire », simple installer, utilisant habituel, permettant simultanee brachial. Hypothese L’objectif principal ce travail montrer fiabilite notre comparant stabilite potentiels evoques mixtes neurogenes (PEMN) enregistres membres superieurs (MS) inferieurs (MI). Notre hypothese que les coefficients variation (CV) PEMN MS MI sont identiques. Patients methode Douze VEPTR (6 patients) ont ete surveillees l’aide stimulateur monopolaire entre 01/01/2012 et 01/09/2014. Les etaient simultanement, toutes 150 secondes, poignets nerf ulnaire creux poplites pres sciatique. Un test rang Wilcoxon pour series appariees applique paires homolaterales CV calcules MI. Resultats Le moyen l’amplitude etait 16,34 % droite (D) 16,67 % gauche (G) 18,30 % 19,75 % MS. latences 1,31 % 1,19 % 1,96 % 1,73 % d’erreur premiere espece d’une difference significative MS/MI 0,5843 0,7312 amplitudes 0,7618 0,4987 latences. Conclusion montage electrode epidurale cathode–plaque sternale anode permet cervicale racines obtenus aussi stables (fiables) Cette technique, facile place, simultane Il semble adapte VEPTR. Niveau preuve IV : etude retrospective, unicentrique, sans randomisation.

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