[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-455086-105":59,"doc-detail-455086-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","near-complete-tongue-transection-during-spinal-surgery-with-transcranial-mep-monitoring-a-case-report","Near-complete tongue transection during spinal surgery with transcranial MEP monitoring - A case report","","Intraoperative neurophysiological monitoring, especially transcranial motor evoked potentials, is central to preventing neural injury during spinal surgery, yet stimulation can provoke forceful jaw closure and cause oral trauma. This case details a 55-year-old woman undergoing multi-level posterior spinal fusion and vertebral column resection, in whom emergence from anesthesia revealed a near-complete left lateral tongue laceration consistent with bite injury from MEP monitoring. Immediate ENT consultation and primary repair were performed, followed by conservative topical policresulen and surveillance. The lesion healed fully without infection, and the patient was discharged in stable condition, highlighting key preventive measures.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/near-complete-tongue-transection-during-spinal-surgery-with-transcranial-mep-monitoring-a-case-report/455086/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/near-complete-tongue-transection-during-spinal-surgery-with-transcranial-mep-monitoring-a-case-report/455086.png","ImageObject",300,407,{"name":92,"@type":93},"Well Done","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What major complication occurred during transcranial MEP monitoring in this case?","Question",{"text":112,"@type":113},"A near-complete laceration of the left lateral tongue was identified during emergence from anesthesia, suggesting bite-induced injury linked to MEP stimulation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the complication treated after it was recognized?",{"text":117,"@type":113},"The patient received immediate otolaryngology consultation and primary repair under general anesthesia, followed by postoperative conservative management with topical policresulen and monitoring.",{"name":119,"@type":110,"acceptedAnswer":120},"What preventive strategies does the report emphasize for MEP-related tongue injuries?",{"text":121,"@type":113},"Soft bite block use, careful oral positioning, intraoperative vigilance—especially in prolonged prone procedures—and early recognition with timely intervention are highlighted as essential preventive steps.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},455086,1790742085,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":52,"preview_page_count":4},5909892210082,"https://ap-avatar.wpscdn.com/avatar/56001069da27c9f41e8?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789614185077863061","®  \n Clinical Case Report   \nNear-complete tongue transection during spinal surgery with transcranial MEP monitoring A case report  \nJaesuk Kim, MDa , Haneul Jeong, MDa , So Young Kwon, MD, PhDa ,*  \n\n| Abstract\u003Cbr>Rationale: IONM, especially transcranial MEPs, is a cornerstone in preventing neural injury during spinal surgery. However, transcranial stimulation may result in forceful jaw closure, causing oral trauma such as tongue lacerations, dental injury, or rarely, airway compromise. This case underscores the importance of recognizing and preventing rare but serious complications related to intraoperative neuromonitoring.\u003Cbr>Patient concerns: A 55-year-old female with progressive lower limb weakness and thoracic kyphotic deformity underwent multi-level posterior spinal fusion and vertebral column resection.\u003Cbr>Diagnoses: A near-complete laceration of the left lateral tongue was noted during emergence from anesthesia, suggesting bite-induced injury from MEP monitoring.\u003Cbr>Interventions: The patient underwent immediate otolaryngology consultation and primary repair under general anesthesia. Postoperative management included conservative treatment with topical policresulen and monitoring.\u003Cbr>Outcomes: The lesion healed fully without infection or further intervention. The patient was discharged in stable condition. Lessons: This report highlights a severe yet preventable complication of MEP monitoring. Soft bite block use, careful oral positioning, and intraoperative vigilance – especially in prolonged prone procedures – are essential preventive strategies. Early recognition and timely intervention are crucial for minimizing morbidity.\u003Cbr>Abbreviations: IONM = intraoperative neurophysiological monitoring, MEP = motor evoked potential, SEP = somatosensory evoked potential, VCR = vertebral column resection. |\n| --- |\n| Keywords: bite injuries, evoked potentials, intraoperative neurophysiological monitoring, motor, postoperative complications, tongue injuries |\n\n1. Introduction  \nIONM, comprising both MEPs and SEPs, is a standard practice in complex spinal surgery to decrease the incidence of neurological compromise. [1,2] These monitoring techniques improve intraoperative safety by delivering continuous assessment of motor and sensory tract integrity during spinal cord manipulation. [1,2]  \nIn procedures targeting the cervical or upper thoracic spine, transcranial MEP monitoring is particularly important, as these regions are more susceptible to injuries affecting the corticospinal tracts innervating both upper and lower limbs. Through MEPs, surgical and anesthesia teams are afforded real-time evaluation of gross motor function, thereby supporting risk reduction in complex cases.  \nHowever, transcranial MEP stimulation may be accompanied by certain complications. [3,4] An often overlooked yet clinically important risk is tongue injury, which can arise from involuntary jaw-closing muscle contractions during highvoltage stimulation. Such events can result in bite trauma, with severity ranging from superficial mucosal abrasions to deep lacerations and hematomas. The reported incidence of tongue injuries related to MEP stimulation is low, ranging from 0.1% to 0.6% in spinal surgeries using neuromonitoring. [5,6] Although minor tongue injuries related to MEP monitoring have been previously documented, to our knowledge, no prior reports have described a near-complete tongue transection caused by transcranial MEP stimulation, making this case exceptionally rare.  \nThe patient has provided informed consent for publication of the case.  \nThe authors have no funding and conflicts of interest to disclose.  \nAll data generated or analyzed during this study are included in this published article [and its supplementary information files].  \nAll procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration a","cbCaig2witBvDM5K","https://ap.wps.com/l/cbCaig2witBvDM5K","pdf",600812,"English","# Introduction\n## Case description and clinical course\n## Discussion and prevention lessons","[{\"question\":\"What major complication occurred during transcranial MEP monitoring in this case?\",\"answer\":\"A near-complete laceration of the left lateral tongue was identified during emergence from anesthesia, suggesting bite-induced injury linked to MEP stimulation.\"},{\"question\":\"How was the complication treated after it was recognized?\",\"answer\":\"The patient received immediate otolaryngology consultation and primary repair under general anesthesia, followed by postoperative conservative management with topical policresulen and monitoring.\"},{\"question\":\"What preventive strategies does the report emphasize for MEP-related tongue injuries?\",\"answer\":\"Soft bite block use, careful oral positioning, intraoperative vigilance—especially in prolonged prone procedures—and early recognition with timely intervention are highlighted as essential preventive steps.\"}]","Near-complete tongue transection during spinal surgery with transcranial MEP monitoring - A case report | PDF"]