DOI: https://doi.org/10.14710/jai.v0i0.59572

Anesthesia Management for Scoliosis Correction Surgery at the Level of Thoracic Vertebra 4 - Lumbar Vertebra 3 with Intraoperative Neurophysiological Monitoring

1Department of Anesthesiology and Intensive Therapy, Prof.dr. Soeharso Orthopaedic Hospital, Surakarta, Indonesia

2Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia

Received: 10 Nov 2023; Revised: 1 Mar 2023; Accepted: 21 Mar 2024; Available online: 21 Mar 2024; Published: 31 Jul 2024.
Open Access Copyright 2024 JAI (Jurnal Anestesiologi Indonesia)

Citation Format:
Cover Image
Abstract

Background: Scoliosis correction surgery in cases of adolescent idiophatic scoliosis (AIS) with the help of intraoperative neurophysiological monitoring (IOM) is an operative technique that aims to increase the safety of surgery in spinal correction by providing a real-time assessment of the underlying nerve structure risk. The management of anesthetic techniques for osteotomy and posterior spinal fusion (PSF) with the help of this IOM requires the expertise of an anesthesiologist to understand influence of anesthetic drugs/ agents on IOM, especially in spinal surgery, the anesthetic technique to be chosen, as well as the selection of drugs and doses that support the operative implementation with this IOM. However, it is important because intraoperative neurophysiocial monitoring can prevent intraoperative neurological injury.

Case: A 14-year-old girl with AIS lenke I who will undergo scoliosis correction surgery for thoracic vertebrae 4 to lumbar vertebra 3 with monitoring using IOM.

Discussion: Neurological injury is the most feared thing that occurs during spinal surgery.The use of intraoperative neurophysiological monitoring (IONM) in spinal surgery is widely used by surgeons to increase safety during direct surgery. Another advantage of using IOM is that it is very sensitive and specific, has a fast response time, and can detect damage at an early stage.

Conclusion: Management of AIS with posterior spine fusion can improve the patient's quality of life, but this must be accompanied by safety during surgery, one of which is the use of IOM.

Note: This article has supplementary file(s).

Fulltext View|Download |  common.other
CTA
Subject
Type Other
  Download (373KB)    Indexing metadata
 common.other
Graphical Abstract
Subject
Type Other
  Download (469KB)    Indexing metadata
Keywords: AIS; anesthesia management; IOM; laminectomy; scoliosis

Article Metrics:

Article Info
Section: Case Reports
Language : EN
Recent articles
Effectivity of Walking Epidural Analgesia in Normal Labor to Reduce Labor Pain and Improve Neonatal Outcome Correlation Between Red Cell Distribution Width (RDW) and Sequential Organ Failure Assessment (SOFA) Score in Sepsis Patients The Relationship Between Interleukin-1β Levels and Visual Analog Scale Value in Preeclampsia Patients Who Received Perioperative C-Sectional Parecoxib With Spinal Anesthesia Anesthesia Management for Scoliosis Correction Surgery at the Level of Thoracic Vertebra 4 - Lumbar Vertebra 3 with Intraoperative Neurophysiological Monitoring Peribulbar Block for Cataract Surgery in Patient with Nystagmus and Chronic Kidney Disease ICU Management of Post-Craniotomy Patients with Schwannoma Vestibular Tumor Removal More recent articles
Most cited articles
Patofisiologi Penyakit Jantung Koroner Midazolam Intravena Dosis Rendah Tidak Mempengaruhi Nitric Oxide Intraperitoneal Mencit Balb/C Yang Terpapar Lipopolisakarida More cited articles
  1. Addai D, Zarkos J, Bowey AJ. Current concepts in the diagnosis and management of adolescent idiopathic scoliosis. Available from: https://doi.org/10.1007/s00381-020-04608-4
  2. Anthony A, Zeller R, Evans C, Dermott JA. Adolescent idiopathic scoliosis detection and referral trends: impact treatment options. Spine Deform. 2021 Jan 1;9(1):75–84
  3. Charalampidis A, Jiang F, Wilson JRF, Badhiwala JH, Brodke DS, Fehlings MG. The Use of Intraoperative Neurophysiological Monitoring in Spine Surgery. Global Spine J. 2020 Jan 1;10(1_suppl):104S-114S
  4. Coșman, M., Atomei, A., Straticiuc, N., Caragea, A., Soare, M., & Neacșu, A. M. Physiological alteration and anaesthetic drugs effects on intraoperative neurophysiological monitoring procedures. Romanian Neurosurgery. 2020;475-81
  5. Kikanloo SR, Tarpada SP, Cho W. Etiology of adolescent idiopathic scoliosis: A literature review. Asian Spine J. 2019 Jun 1;13(3):519–26
  6. Murphy RF, Mooney JF. Complications following spine fusion for adolescent idiopathic scoliosis. Vol. 9, Current Reviews in Musculoskeletal Medicine. Humana Press Inc.; 2016. p. 462–9
  7. Lall RR, Hauptman JS, Munoz C, Cybulski GR, Koski T, Ganju A, et al. Intraoperative neurophysiological monitoring in spine surgery: Indications, efficacy, and role of the preoperative checklist. Neurosurg Focus. 2012;33(5)
  8. Park JH. Intraoperative neurophysiological monitoring in spinal surgery. World J Clin Cases. 2015;3(9):765
  9. Chang SH, Park YG, Kim DH, Yoon SY. Monitoring of motor and somatosensory evoked potentials during spine surgery: Intraoperative changes and postoperative outcomes. Ann Rehabil Med. 2016;40(3):470–80
  10. Khanna P, Sarkar S, Garg B. Anesthetic considerations in spine surgery: What orthopaedic surgeon should know! Vol. 11, Journal of Clinical Orthopaedics and Trauma. Elsevier B.V.; 2020. p. 742–8
  11. Afr S, Analg JA. An approach to anaesthesia for scoliosis repair. Supplement Southern African Journal of Anaesthesia and Analgesia [Internet]. 2021;27(6):1–55. Available from: http://www.sajaa.co.zahttp://creativecommons.org/licenses/by-nc/3.0
  12. Huh S, Eun LY, Kim NK, Jung JW, Choi JY, Kim HS. Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children. Korean J Pediatr. 2015 Jun 15;58(6):218–23
  13. Sedra F, Shafafy R, Sadek AR, Aftab S, Montgomery A, Nadarajah R. Perioperative Optimization of Patients With Neuromuscular Disorders Undergoing Scoliosis Corrective Surgery: A Multidisciplinary Team Approach. Vol. 11, Global Spine Journal. SAGE Publications Ltd; 2021. p. 240–8
  14. NSW Government. Pre and Post Operative Care of the Scoliosis/Kyphosis. [cited feb 25 2024]. Available from: https://resources.schn.health.nsw.gov.au/policies/policies/2008-8113.pdf
  15. Bajwa S, Kulshrestha A. Spine Surgeries: Challenging Aspects And Implications For Anaesthesia. J Spine Neurosurg. 2013;02(03)
  16. Nowicki RWA. Anaesthesia for major spinal surgery. Continuing Education in Anaesthesia, Critical Care and Pain. 2014;14(4):147–52
  17. Kiss EE, Chandran N, Alex G, Olomu P. Anesthetic Challenges of an Adolescent Patient with Epidermolysis Bullosa and Gitelman’s Syndrome Undergoing Posterior Spinal Fusion Surgery. J Pediatr Genet. 2021 Jun;10(02):152–5
  18. Castro-Gómez, Alex, and Luis Antonio Delgado. "Tracheal intubation in the prone position: Another way to access the airway." Colombian journal of anesthesiology 45.4 (2017): 340-343
  19. Kishimoto T, Hayashi S, Nakanishi Y, Goto T, Kosugi K, Sakurai S. Use of the Microcuff® During General Anesthesia for Patients With Scoliosis. Anesth Prog. 2020 Mar 1;67(1):23–7
  20. Kundnani V, Zhu L, Tak H, Wong H. Multimodal intraoperative neuromonitoring in corrective surgery for adolescent idiopathic scoliosis: Evaluation of 354 consecutive cases. Indian J Orthop. 2010 Jan 1;44(1):64–72
  21. Seok Young Chung, Chae Hwan Lim, Yoon Ghil Park, Hak Sun Kim. Hemodynamic Consideration in Intraoperative Neurophysiological Monitoring in Neuromuscular Scoliosis Surgery
  22. Anesthetic considerations during intraoperative neurophysiological monitoring in spine surgery
  23. Sahinovic MM, Gadella MC, Shils J, Dulfer SE, Drost G. Anesthesia and intraoperative neurophysiological spinal cord monitoring. Vol. 34, Current opinion in anaesthesiology. NLM (Medline); 2021. p. 590–6
  24. Bithal P. Anaesthetic considerations for evoked potentials monitoring. J Neuroanaesth Crit Care. 2014 Apr;01(01):002–12
  25. Licina A, Silvers A, Laughlin H, Russell J, Wan C. Pathway for enhanced recovery after spinal surgery-a systematic review of evidence for use of individual components. BMC Anesthesiol. 2021 Dec 1;21(1)
  26. Lin WL, Lee MS, Wong CS, Chan SM, Lai HC, Wu ZF, et al. Effects of intraoperative propofol-based total intravenous anesthesia on postoperative pain in spine surgery: Comparison with desflurane anesthesia - A randomised trial. Medicine (United States). 2019;98(13)
  27. Cheng SS, Yeh J, Flood P. Anesthesia matters: Patients anesthetized with propofol have less postoperative pain than those anesthetized with isoflurane. Anesth Analg. 2008;106(1):264–9
  28. Joseph D. Tobias; Timothy J. Goble; Guy Bates; John T. Anderson; Daniel G. Hoernschemeyer. Effects of dexmedetomidine on intraoperative motor and somatosensory evoked potential monitoring during spinal surgery in adolescents. 2008;18(11):1082–8
  29. Seki H, Ideno S, Ishihara T, Watanabe K, Matsumoto M, Morisaki H. Postoperative pain management in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis: A narrative review. Scoliosis Spinal Disord. 2018 Sep 12;13(1)
  30. Young CD, McLuckie D, Spencer AO. Anaesthetic care for surgical management of adolescent idiopathic scoliosis. Vol. 19, BJA Education. Elsevier Ltd; 2019. p. 232–7
  31. Geisler A, Zachodnik J, Køppen K, Chakari R, Bech-Azeddine R. Postoperative pain treatment after spinal fusion surgery: A systematic review with meta-analyses and trial sequential analyses. Vol. 7, Pain Reports. Lippincott Williams and Wilkins; 2022. p. E1005
  32. Seki H, Ideno S, Ishihara T, Watanabe K, Matsumoto M, Morisaki H. Postoperative pain management in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis: A narrative review. Scoliosis Spinal Disord. 2018 Sep 12;13(1)

Last update:

No citation recorded.

Last update: 2024-12-21 20:10:15

No citation recorded.