Motor-evoked potential monitoring from urinary sphincter muscle during pediatric untethering surgery: a case series
Purpose Postoperative urinary dysfunction following untethering surgery for spinal lipoma is devastating. To assess urinary function, we invented a pediatric urinary catheter equipped with electrodes for the direct transurethral recording of myogenic potential from the external urethral sphincter (EUS). This paper presents two cases in which urinary function was monitored intraoperatively by recording of motor-evoked potential (MEP) from EUS during untethering surgery in children. Methods Two children (aged 2 and 6 years) were included in this study. One patient had no preoperative neurological dysfunction, while the other had frequent urination and urinary incontinence. A pair of surface electrodes was attached to a silicone rubber urethral catheter (6 or 8 Fr; diameter, 2 or 2.6 mm). The MEP from the EUS was recorded to assess the function of the centrifugal tract from the motor cortex to the pudendal nerve. Results Baseline MEP waveforms from the EUS were successfully recorded with latency and amplitude of 39.5 ms and 66 µV in patient 1 and 39.0 ms and 113 µV in patient 2, respectively. A significant decrease in amplitude was not observed during surgery in the two cases. No new urinary dysfunction and complications associated with the urinary catheter-equipped electrodes developed postoperatively. Conclusion Using an electrode-equipped urinary catheter, monitoring of MEP from the EUS could be applicable during untethering surgery in pediatric patients..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
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| Enthalten in: |
Child's nervous system - 39(2023), 8 vom: 09. März, Seite 2147-2153 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ogawa, Yuki [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Motor-evoked potential |
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s00381-023-05895-3 |
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| 520 | |a Purpose Postoperative urinary dysfunction following untethering surgery for spinal lipoma is devastating. To assess urinary function, we invented a pediatric urinary catheter equipped with electrodes for the direct transurethral recording of myogenic potential from the external urethral sphincter (EUS). This paper presents two cases in which urinary function was monitored intraoperatively by recording of motor-evoked potential (MEP) from EUS during untethering surgery in children. Methods Two children (aged 2 and 6 years) were included in this study. One patient had no preoperative neurological dysfunction, while the other had frequent urination and urinary incontinence. A pair of surface electrodes was attached to a silicone rubber urethral catheter (6 or 8 Fr; diameter, 2 or 2.6 mm). The MEP from the EUS was recorded to assess the function of the centrifugal tract from the motor cortex to the pudendal nerve. Results Baseline MEP waveforms from the EUS were successfully recorded with latency and amplitude of 39.5 ms and 66 µV in patient 1 and 39.0 ms and 113 µV in patient 2, respectively. A significant decrease in amplitude was not observed during surgery in the two cases. No new urinary dysfunction and complications associated with the urinary catheter-equipped electrodes developed postoperatively. Conclusion Using an electrode-equipped urinary catheter, monitoring of MEP from the EUS could be applicable during untethering surgery in pediatric patients. | ||
| 650 | 4 | |a Motor-evoked potential | |
| 650 | 4 | |a Pediatrics | |
| 650 | 4 | |a Postoperative urinary dysfunction | |
| 650 | 4 | |a Untethering surgery | |
| 650 | 4 | |a Spinal lipoma | |
| 650 | 4 | |a Transurethral recording | |
| 700 | 1 | |a Hayashi, Hironobu |0 (orcid)0000-0002-4352-0423 |4 aut | |
| 700 | 1 | |a Sasaki, Ryota |4 aut | |
| 700 | 1 | |a Takatani, Tsunenori |4 aut | |
| 700 | 1 | |a Oi, Ayako |4 aut | |
| 700 | 1 | |a Uemura, Keiko |4 aut | |
| 700 | 1 | |a Kawaguchi, Masahiko |4 aut | |
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