Application of radial artery pressure combined with somatosensory evoked potential monitoring on protection of brachial plexus during ankylosing spondylitis surgery

Abstract

Objective To observe the effects of radial artery pressure combined with somatosensory evoked potential monitoring on decreasing the incidence of brachial plexus paralysis in ankylosing spondylitis (AS) patients with kyphosis of thoracic and lumbar vertebra who were corrected surgically by pedicle subtraction osteotomy (PSO). Methods A total of 36 AS patients with kyphosis of thoracic and lumbar vertebra undergoing the surgery of PSO were selected from January 2014 to December 2014. During surgery, all patients were applied with artery pressure combined with somatosensory evoked potential monitoring for protecting brachial plexus. Results Positive monitoring indicators occurred in 2 patients during surgery. And then, the monitoring indicators returned to normal by adjusting body position on time; they were not with the symptom of brachial plexus paralysis after surgery. However, positive monitoring indicators occurred in 1 patient and didn′t return to normal by repeatedly adjusting body position. Thus, the patient was found with the symptom of mild brachial plexus paralysis after surgery and returned to normal at 1 week after treatment. There were no neural complications caused by operation during surgery. Conclusions Radial artery pressure combined with somatosensory evoked potential monitoring can indicate the change of compression degree of the brachial plexus in AS patients with kyphosis of thoracic and lumbar vertebra undergoing the surgery of PSO, and it can effectively decrease the incidence of brachial plexus paralysis by appropriate treatment. Key words: Anxiety; Somatosensory evoked potential monitoring; Ankylosing spondylitis; Protection of brachial plexus