Sciatic Nerve Monitoring in Acetabular Surgeries

Abstract

ABSTRACT.Surgical repair of acetabular fractures puts the sciatic nerve at risk for iatrogenic injury. The status of the sciatic nerve can be effectively monitored with somatosensory evoked responses to peroneal and posterior tibial stimulation. The most stable response for monitoring is measured at T12. The unaffected leg can serve as the control with the interlimb amplitude ratio providing a sensitive measure of nerve function. In 88 consecutive cases we monitored, 55 had one or more interventions based on evoked potential findings. Of these 55 patients, 14 had electrophysiologic changes that did not recover to baseline and 41 had full recovery following each intervention. Yet only two patients demonstrated a new sciatic nerve postoperatively.