Role of intraoperative electrophysiological monitoring during ...

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Statistical analysis: It is performed by SPSS (Statistical programme of social signs) version 8.0 as follows: Description of quantitative variables in the form of mean, standard deviation and range; description of qualitative variables in the form of numbers and percentage; and paired t-test used to compare change in mean values after six months of the intervention within groups as regard quantitative variables. Results of comparisons are considered not significant if (p 0.05, significant if (p 0.05), highly significant if (p 0.01) and very highly significant if (p 0.001). 6
Results: From the twenty-two children, there were 12 patients with diplegia (54%), and 10 patients with quadriplegia (46 %). In all patients, the underlying etiology was perinatal hypoxia. In thirteen severely disabled children, the goal of surgery was to facilitate comfort and care, and in nine children the aim was to improve ambulation. Mean number of tested rootlets in each level was 5.5 on right side and 6 on left side; mean number of cut rootlets was 3 on both sides. 52.8% of stimulated rootlets in each stimulated dorsal root graded as 3+ or 4+ were selected to be sectioned in all children (Fig 2). In 6 children (27%), the S1 dorsal root produced anal sphincter contraction so it was spared. Four (18%) of those children who had intraoperative anal sphincter response upon stimulation of either S1 dorsal root were able to control sphincters preoperatively. In one child, the grade 3+ or 4+ were met in L4 and L5 dorsal roots bilaterally only, while none of the other stimulated roots had met the criteria. Postoperatively, bowel control is preserved in all continent 8 children (100%). Figure 2: Percentage of transected rootlets (grades 3+ and 4+) Clinical outcome after 6 months of the 8 cases revealed significant increase of ROM of hip abduction; insignificant decrease of spasticity of adductor muscles; and insignificant improvement of motor power of quadriceps (Table 2 and Fig. 3). A six-month followup duration may be short for assessment of motor outcome, but is not for assessment of sphincter control outcome which is the main point of this work. Table 2: Mean outcome measurements Outcome parameter Baseline (preop) 6months postop P value Notes Spasticity of hip adductors 4.13 1.51 0.2 Insignificant decrease Range of motion of hip abductor 68.85 95.85 0.03 Significant muscles (degrees) increase Motor power (MRCS) 2.75 3.2 0.32 Insignificant increase 7
Page 1 and 2: Role of intraoperative electrophysi
Page 3 and 4: Methods: Twenty-two children (fourt
Page 5: Table 1: Grading of Motor Responses
Page 9: Discussion: The concept of SDR is i
Page 12 and 13: References: 1. Bohannon RW, Smith M

Role of intraoperative electrophysiological monitoring during ...

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