1. Symptomatic Spinal Cord Bending After Meningioma Resection
- Author
-
Sergio Paolini, Serena Tola, Simona Bistazzoni, Vincenzo Esposito, and Paolo Missori
- Subjects
Adult ,medicine.medical_specialty ,Cord ,Intraoperative Neurophysiological Monitoring ,Physiology ,Tumor resection ,intraoperative monitoring ,evoked potentials ,Neurosurgical Procedures ,Resection ,Meningioma ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Meningeal Neoplasms ,medicine ,Humans ,Spinal Cord Neoplasms ,030212 general & internal medicine ,Evoked potential ,business.industry ,Dentate ligament ,meningioma ,motor evoked ,spinal cord ,adult ,motor ,female ,humans ,intraoperative neurophysiological monitoring ,meningeal neoplasms ,neurosurgical procedures ,spinal cord neoplasms ,physiology ,neurology ,neurology (clinical) ,physiology (medical) ,Evoked Potentials, Motor ,Spinal cord ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Spinal Cord ,Neurology ,Female ,Neurology (clinical) ,Complication ,business ,030217 neurology & neurosurgery ,Intraoperative neurophysiological monitoring - Abstract
Resection of intradural tumors is often followed by bending of the spinal cord within the surgical cave. This event is known to be innocuous. The authors report a case where the position assumed by the spinal cord at the end of surgery was associated with significant motor evoked potential decline. The patient, a 44-year-old woman with a meningioma of the craniocervical junction, underwent tumor resection aided by intraoperative neurophysiological monitoring. At the time of dural closure, the motor evoked potentials were completely lost on the left side and reduced on the right side. Intraoperative maneuvers showed that worsening was related to the spinal cord position. Motor evoked potentials were restored by tethering the cord posteriorly, back to its original site. This report underlines the usefulness of maintaining intraoperative monitoring until the end of surgery and provides a technical nuance to manage a rare complication.
- Published
- 2016