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Evaluation of sciatic nerve compromise during total hip arthroplasty
Clinical Orthopaedics and Related Research
|December 1, 1985
Summary
Somatosensory evoked potentials (SEP) monitored sciatic nerve function during hip arthroplasty. Twelve temporary nerve compromises occurred, highlighting the utility of SEP monitoring, especially in revision surgeries.
Area of Science:
- Orthopedic Surgery
- Neurophysiology
- Surgical Monitoring
Background:
- Total hip arthroplasty (THA) is a common procedure.
- Potential for sciatic nerve injury exists during THA.
- Intraoperative monitoring can detect nerve compromise.
Purpose of the Study:
- To assess sciatic nerve function during THA using somatosensory evoked potentials (SEP).
- To identify causes and incidence of temporary nerve compromise during THA.
- To evaluate the utility of SEP monitoring in THA.
Main Methods:
- Somatosensory evoked potentials (SEP) were used to monitor sciatic nerve function.
- Monitoring was performed intraoperatively in 50 patients undergoing THA.
- Nerve compromise events were recorded and analyzed.
Main Results:
- Twelve instances of temporary sciatic nerve compromise were observed in ten patients.
- Compromises occurred during acetabular preparation, femoral reaming, and trial reduction.
- Specific causes included retraction, reamer contact, positioning, and inadequate femoral neck shortening.
Conclusions:
- SEP monitoring is a viable technique for assessing sciatic nerve function during THA.
- Understanding the causes of nerve compromise can inform surgical practice.
- SEP monitoring may be particularly beneficial in complex revision THA cases.