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Related Experiment Video

Updated: Jul 18, 2026

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
04:33

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

Generalized peripheral nerve failure during thoracic spine surgery: a case report.

Allison J Bethune1, David A Houlden, Terry S Smith

  • 1Sunnybrook and Women's HSC, Surgical Neuromonitoring, 2075 Bayview Ave, Suite B506, Toronto, ON, Canada M4N 3M5. allison.bethune@utoronto.ca

Journal of Clinical Monitoring and Computing
|November 23, 2006
PubMed
Summary

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Somatosensory evoked potential (SSEP) monitoring detected a generalized nerve conduction block during spine surgery, caused by a kinked endotracheal tube. This electrophysiological technique can identify systemic impairments not related to surgical manipulation.

Area of Science:

  • Neurophysiology
  • Surgical Monitoring
  • Anesthesiology

Background:

  • Intraoperative systemic changes can impair peripheral nerve function, often undetected by standard electrophysiology.
  • Somatosensory evoked potentials (SSEPs) offer a method to monitor global peripheral nerve excitability.

Purpose of the Study:

  • To illustrate how SSEP monitoring can detect systemic changes affecting peripheral nerve function during spine surgery.
  • To highlight the utility of SSEPs in identifying non-surgical causes of nerve conduction impairment.

Main Methods:

  • Posterior thoracic spine fixation performed on a young male with multiple traumatic injuries.
  • Bilateral tibial nerve SSEPs and right median nerve SSEP were recorded intraoperatively.
  • Monitoring included airway resistance, blood pressure, and end-tidal CO2.

Related Experiment Videos

Last Updated: Jul 18, 2026

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
04:33

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

Main Results:

  • A rapid, progressive loss of tibial and median nerve SSEPs occurred 90 minutes post-anesthetic induction.
  • Elevated airway resistance and low blood pressure were noted; oxygenation and fluid volume were adequate.
  • SSEPs recovered in 2 of 3 limbs; the cause was identified as a kinked endotracheal tube.

Conclusions:

  • SSEP monitoring can detect uncommon generalized nerve conduction blocks during spine surgery.
  • This technique alerts surgical teams to systemic impairments unrelated to surgical manipulation.
  • A compromised endotracheal tube leading to increased airway resistance was identified as the cause.