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dc.contributor.authorEck, Jason C.
dc.contributor.authorMartin, Christopher J.
dc.contributor.authorLapinsky, Anthony
dc.contributor.authorConnolly, Patrick J.
dc.contributor.authorDiPaola, Christian P.
dc.date2022-08-11T08:10:08.000
dc.date.accessioned2022-08-23T16:56:26Z
dc.date.available2022-08-23T16:56:26Z
dc.date.issued2013-02-01
dc.date.submitted2013-03-11
dc.identifier.citationJ Clin Monit Comput. 2013 Feb;27(1):93-6. doi: 10.1007/s10877-012-9395-4. <a href="http://dx.doi.org/10.1007/s10877-012-9395-4">Link to article on publisher's site</a>
dc.identifier.issn1387-1307 (Linking)
dc.identifier.doi10.1007/s10877-012-9395-4
dc.identifier.pmid22941585
dc.identifier.urihttp://hdl.handle.net/20.500.14038/42930
dc.description.abstractTo present a case report of a patient with an ASIA B spinal cord injury with partially intact baseline IONM who made a complete functional recovery postoperatively. A thirty-three year old male presented after a motor vehicle accident. Imaging studies revealed a C4-C5 bilateral facet dislocation. On presentation the patient had 4/5 strength in bilateral biceps and wrist extensors, 3/5 strength in bilateral triceps, and 0/5 strength in the finger flexors, intrinsics and all lower extremity muscles. Motor level was C7. Sensation was grossly intact to light touch throughout all extremities, intact to pinprick from C2 to T7, and absent to pinprick caudal to T7. Rectal tone and contraction were absent. After attempts at closed reduction failed the patient underwent an open reduction and posterior C4-C5 fusion. Intraoperative neurophysiologic monitoring (IONM) revealed the presence of baseline responses to the posterior tibial nerve using somatosensory evoked potentials and to the right abductor hallucis using transcranial motor evoked potentials. At the 6 weeks postoperative visit the patient had full 5/5 motor strength to all muscles except the left deltoid that was 4/5 due to a rotator cuff injury. This case illustrates a potential prognostic value of IONM. Despite lack of clinical motor function at the time of surgery, IONM was able to illicit a motor response in the right lower extremity. Further prospective studies are needed for further investigation.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=22941585&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1007/s10877-012-9395-4
dc.subjectSpinal Cord Injuries
dc.subjectMonitoring, Intraoperative
dc.subjectNervous System Diseases
dc.subjectOrthopedics
dc.subjectRehabilitation and Therapy
dc.subjectSurgery
dc.titleDoes intraoperative neurophysiological monitoring have predictive value for functional recovery following spinal cord injury? A case report
dc.typeJournal Article
dc.source.journaltitleJournal of clinical monitoring and computing
dc.source.volume27
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ortho_pp/133
dc.identifier.contextkey3889059
html.description.abstract<p>To present a case report of a patient with an ASIA B spinal cord injury with partially intact baseline IONM who made a complete functional recovery postoperatively. A thirty-three year old male presented after a motor vehicle accident. Imaging studies revealed a C4-C5 bilateral facet dislocation. On presentation the patient had 4/5 strength in bilateral biceps and wrist extensors, 3/5 strength in bilateral triceps, and 0/5 strength in the finger flexors, intrinsics and all lower extremity muscles. Motor level was C7. Sensation was grossly intact to light touch throughout all extremities, intact to pinprick from C2 to T7, and absent to pinprick caudal to T7. Rectal tone and contraction were absent. After attempts at closed reduction failed the patient underwent an open reduction and posterior C4-C5 fusion. Intraoperative neurophysiologic monitoring (IONM) revealed the presence of baseline responses to the posterior tibial nerve using somatosensory evoked potentials and to the right abductor hallucis using transcranial motor evoked potentials. At the 6 weeks postoperative visit the patient had full 5/5 motor strength to all muscles except the left deltoid that was 4/5 due to a rotator cuff injury. This case illustrates a potential prognostic value of IONM. Despite lack of clinical motor function at the time of surgery, IONM was able to illicit a motor response in the right lower extremity. Further prospective studies are needed for further investigation.</p>
dc.identifier.submissionpathortho_pp/133
dc.contributor.departmentDepartment of Orthopedic Surgery
dc.contributor.departmentDepartment of Orthopedics and Physical Rehabilitation
dc.source.pages93-6


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