naa a22 4500 510760376 CHVBK 20180411083137.0 cr unu---uuuuu 180411e20131001xx s 000 0 eng 10.1007/s11420-013-9347-7 doi (NATIONALLICENCE)springer-10.1007/s11420-013-9347-7 Neurophysiologic Monitoring Can Predict Iatrogenic Injury During Acetabular and Pelvic Fracture Fixation [Elektronische Daten] [Manny Porat, Fabio Orozco, Nitin Goyal, Zachary Post, Alvin Ong] Background:: Nerve injury during acetabular and pelvic fracture fixation can have devastating consequences for trauma patients already in a compromised situation. Questions/Purposes:: This study aims to evaluate the efficacy of multimodality intraoperative neurophysiologic monitoring during acetabular and pelvic fracture fixation in identifying emerging iatrogenic nerve injury. Methods:: Sixty patients were retrospectively identified after surgical fixation following acetabular or pelvic fracture. Neuromonitoring during surgery was performed using three different modalities, transcranial electric motor evoked potential (tceMEP), somatosensory evoked potential (SSEP), and electromyographic (EMG) monitoring. Each modality was evaluated for sensitivity and specificity of detecting an intraoperative nerve injury. Results:: tceMEP monitoring was found to be 100% sensitive and 86% specific at detecting an impending nerve injury. The sensitivity and specificity of SSEP were 75% and 94%, while EMG sensitivity was unacceptably low at 20% although specificity was 93%. Conclusions:: Multimodality neuromonitoring of transcranial electric motor and peroneal nerve somatosensory evoked potentials with or without spontaneous EMG monitoring is a safe and effective method for detecting impending nerve injury during acetabular and pelvic surgery. Hospital for Special Surgery, 2013 neurophysiologic monitoring nationallicence acetabular fracture nationallicence pelvic fracture nationallicence Porat Manny Reconstructive Orthopedics, 737 Main Street, Suite 6, 08048, Lumberton, NJ, USA aut Orozco Fabio Rothman Institute, 2500 English Creek Avenue, Building 1300, 08234, Egg Harbor Township, NJ, USA aut Goyal Nitin Anderson Orthopaedic Clinic, 2445 Army Navy Drive, 22206, Arlington, VA, USA aut Post Zachary Rothman Institute, 2500 English Creek Avenue, Building 1300, 08234, Egg Harbor Township, NJ, USA aut Ong Alvin Rothman Institute, 2500 English Creek Avenue, Building 1300, 08234, Egg Harbor Township, NJ, USA aut HSS Journal ® Springer US; http://www.springer-ny.com 9/3(2013-10-01), 218-222 1556-3316 9:3<218 2013 9 11420 https://doi.org/10.1007/s11420-013-9347-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11420-013-9347-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Porat Manny Reconstructive Orthopedics, 737 Main Street, Suite 6, 08048, Lumberton, NJ, USA aut NATIONALLICENCE 700 1- Orozco Fabio Rothman Institute, 2500 English Creek Avenue, Building 1300, 08234, Egg Harbor Township, NJ, USA aut NATIONALLICENCE 700 1- Goyal Nitin Anderson Orthopaedic Clinic, 2445 Army Navy Drive, 22206, Arlington, VA, USA aut NATIONALLICENCE 700 1- Post Zachary Rothman Institute, 2500 English Creek Avenue, Building 1300, 08234, Egg Harbor Township, NJ, USA aut NATIONALLICENCE 700 1- Ong Alvin Rothman Institute, 2500 English Creek Avenue, Building 1300, 08234, Egg Harbor Township, NJ, USA aut NATIONALLICENCE 773 0- HSS Journal ® Springer US; http://www.springer-ny.com 9/3(2013-10-01), 218-222 1556-3316 9:3<218 2013 9 11420 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer