Camilla  Arvinius,Elena Manrique-Gamo,Hector Marcelo,Juan-Luis Cebrian,Roberto Garcia-Maroto,Susana Martín-Albarrán,
Neurophysiological Monitoring During Large Femoral and Pelvic Tumoral Resections
Surgery Case Reports
2020
2733-225X
http://dx.doi.org/10.31487/j.JSCR.2020.01.02
https://www.sciencerepository.org/neurophysiological-monitoring-during-large-femoral_JSCR-2020-1-102 
Abstract: Background: Oncological femoral or pelvic resections and reconstruction have become an alternative to
large amputations. However, one of the frequent risks is the neurological injury. The use of intraoperative
evoked potentials allows its control in order to modify the surgical gestures. The purpose of this study was
to evaluate the results of intraoperative neurophysiologic monitoring in large reconstructive arthroplasty
surgeries.
Case presentation: A prospective study (2012-2018) was performed, including 8 patients with 6 complete
resections of the femur and 2 resections of the pelvis. In all cases, intraoperative lumbar plexus monitoring
was performed using evoked potentials in order to analyze variations during surgery as well as a
postoperative control. 100% could be correctly monitored throughout the surgery. In 4 cases, intraoperative
anomalies were detected requiring modification of the surgery. Of these, postoperatively only one nerve
injury persisted: a complete sciatic nerve injury due to an intraoperative vascular injury.
Conclusion: Intraoperative neurophysiological monitoring is a very useful resource in large oncological
resection, allowing detection of nerve distress due to manipulation or excessive limb traction during
reconstruction. The use of somatosensory evoked potentials in large oncological resections can predict and
minimize the risk of relevant postoperative nerve complicationsKeywords: Neurophysiological monitoring, intraoperative monitoring, tumor, reconstructive surgery, resection