A multicentre retrospective review of XXXX of the leg following spinal surgery with motor evoked potential monitoring: a cause for concern?

@entity1 @entity2054 @entity291 @entity121
PURPOSE: There are very few reported cases of @entity2054 following spinal surgery via a posterior approach. An association between @entity2054 and muscle over-activity via nerve stimulation during evoked potential monitoring was first suggested in 2003. No further reports have suggested this link. We present a multicentre retrospective review of a series of five @entity1 who developed @entity2054 following spinal surgery via a posterior approach, whilst un-paralysed and with combined sensory (SSEP)/motor evoked potential (MEP) monitoring with an aim of highlighting this possible causative factor. METHODS: All data were collected contemporaneously and retrospective analysis was performed. We then arranged for a multidisciplinary review of the cases including surgeons, anaesthetists, radiologists, neurophysiologists and theatre and ward nursing staff. Finally, the literature was reviewed. RESULTS: All @entity1 were operated on by three different surgeons, on different operating tables/mattresses in the prone position. The common factors were un-paralysed @entity1 having motor/sensory monitoring, mechanical @entity291 pumps and total intravenous anaesthesia. Three @entity1 underwent surgical decompression of their compartments and two were treated expectantly. Three @entity1 had confirmed intra-compartmental changes on MRI consistent with @entity2054 and one had intra-compartmental pressure monitoring which confirmed the diagnosis. CONCLUSIONS: Previous cases in the literature have related to mal-positioning on the Jackson table or use of the knee-chest position for surgery. This was not the case for our @entity1 ; therefore, we suspect an association between overactive muscle stimulation and @entity121 . Further experimental studies investigating this link are required.
