Guideline: Monitoring Spinal Cord During Surgery May Help Prevent Paralysis

February 21, 2012

The American Academy of Neurology is issuing an updated guideline that recommends monitoring the spinal cord during spinal surgery and certain chest surgeries to help prevent paralysis, or loss of muscle function, related to the surgeries. The guideline, which was developed with the American Clinical Neurophysiology Society and co-authored by Gloria Galloway, MD, attending neurologist at Nationwide Children's Hospital, is published in the February 21, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology and also in the Journal of Clinical Neurophysiology.

According to the guideline, strong evidence shows that monitoring the spinal cord during spinal surgery and certain chest surgeries, such as those performed to repair narrowing of the walls of the aorta, can help prevent paralysis that can be related to the surgery. Also known as intraoperative monitoring, the procedure can alert the surgeon in time to find and address the problem before damage occurs.

“Paraparesis, paraplegia, and quadriplegia are potential serious complications of surgeries where the spinal cord is at risk,” said guideline lead author Marc R. Nuwer, MD, PhD, of UCLA and a Fellow of the American Academy of Neurology. “Monitoring can help prevent damage by identifying problems early enough to allow for interventions. If intraoperative monitoring raises warnings, surgeons and anesthesiologists can modify the surgery to reduce the risk of these complications.”

Intraoperative monitoring of the spinal cord involves monitoring of somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs). The guideline found that in all cases where paralysis occurred, the patients had changes in their evoked potentials during the surgery, while there were no cases of paralysis in patients without any changes in their evoked potentials.

“The best way to treat paralysis is to prevent it in the first place,” said Nuwer. “Spinal cord monitoring supervised by a neurologist can help meet this goal.”

Learn more about this latest guideline and spinal cord injury at http://www.aan.com/patients.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com, www.aan.com/go/pressroom or find us on Facebook, Twitter, Google+ and YouTube.

Additional Media Contacts:
Rachel Seroka, rseroka@aan.com, (651) 695-2738
Angela Babb, APR, ababb@aan.com, (651) 695-2789

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2017-18 list of “America’s Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric healthcare systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of nearly 13,000 providing state-of-the-art pediatric care during more than 1.4 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at NationwideChildrens.org.