Neurophysiological Monitoring During Large Femoral and Pelvic Tumoral Resections

Author Info

Camilla Arvinius Elena Manrique-Gamo Hector Marcelo Juan-Luis Cebrian Roberto Garcia-Maroto Susana Martín-Albarrán

Corresponding Author

Camilla Arvinius
Hospital Clínico San Carlos, Calle Profesor Martín Lagos s/n. 208040 Madrid, Spain

A B S T R A C T

Background: Oncological femoral or pelvic resections and reconstruction have become an alternative to large amputations. However, one of the frequent risks is the neurological injury. The use of intraoperative evoked potentials allows its control in order to modify the surgical gestures. The purpose of this study was to evaluate the results of intraoperative neurophysiologic monitoring in large reconstructive arthroplasty surgeries. Case presentation: A prospective study (2012-2018) was performed, including 8 patients with 6 complete resections of the femur and 2 resections of the pelvis. In all cases, intraoperative lumbar plexus monitoring was performed using evoked potentials in order to analyze variations during surgery as well as a postoperative control. 100% could be correctly monitored throughout the surgery. In 4 cases, intraoperative anomalies were detected requiring modification of the surgery. Of these, postoperatively only one nerve injury persisted: a complete sciatic nerve injury due to an intraoperative vascular injury. Conclusion: Intraoperative neurophysiological monitoring is a very useful resource in large oncological resection, allowing detection of nerve distress due to manipulation or excessive limb traction during reconstruction. The use of somatosensory evoked potentials in large oncological resections can predict and minimize the risk of relevant postoperative nerve complications

Article Info

Article Type

Case Report

Publication history

Received: Thu 02, Jan 2020
Accepted: Tue 21, Jan 2020
Published: Mon 27, Jan 2020

Copyright

© 2023 Camilla Arvinius. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSCR.2020.01.02