Comparação entre o teste de despertar e a monitoração neurofisiológica intra-operatória com potencial evocado somato-sensitivo nas cirurgias de escoliose

• Autor(a) principal: Puertas, Eduardo Barros [UNIFESP]
• Data de Publicação: 2009
• Outros Autores: Wajchenberg, Marcelo [UNIFESP], Ferreira, Ricardo [UNIFESP], Scamardi, Fabio Fernando Roman [UNIFESP], Trandafilov Júnior, Miguel [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S1808-18512009000100003; http://repositorio.unifesp.br/handle/11600/4940
• topic: Scoliosis; Intraoperative complications; Paraplegia; Monitoring; Evoked potentials, somatosensory; Escoliose; Complicações intra-operatória; Paraplegia; Monitoramento; Potenciais somatosensoriais evocados

OBJECTIVE: the objective of this study is to compare the incidence of neurological injuries in corrective surgeries for rigid curves of idiopathic scoliosis using only the wake-up test and using the intraoperative neurophysiologic monitoring with somato sensitive evoked potentials. METHODS: we performed 111 surgeries to correct idiopathic scoliosis, with rigid curves through instrumentation and posterior fusion in the period January 1985 to May 2001. The procedures were divided into two groups, with 80 patients operated without the intra-operative monitoring, using only the wake-up test, from January 1985 to January 1998. From May 1998 the surgeries began to be monitored with somato-sensitive evoked potential (PESS) for prevention of neurological damage, forming a second group of 31 patients. RESULTS: in the first group, one patient had irreversible neurological damage and four patients had reversible neurological damage. Among the 31 patients in the second group, with s somato-sensitive evoked potential during surgery, eight had reversible neurological damage in the intra-operatory, without any clinical effect after the procedure. CONCLUSION: the findings suggest the effectiveness of intra-operative monitoring, with the somato-sensitive evoked potential, for the prevention of neurological injuries in the corrective surgeries of rigid curves in idiopathic scoliosis.