THE ROLE OF INTRAOPERATIVE NEUROPHYSIOLOGIC MONITORING TO ENHANCE SUCCESSFUL ORTHOPEDIC SURGERY

One of the main advance in orthopaedic surgery domain has a goal to investigates the safest and harmless method in surgical procedures. Less complications means a better outcome of surgery. One of the commonest risks at orthopaedic surgery is central and peripheral nerve injury. The modality of Intraoperative Neurophysiologic Monitoring (IONM) which act to limit the risk of nerve injury during operative procedure through the evaluation of nerve integrity and function enable the surgeon to decrease injury to the nerve associated with orthopaedic surgical procedure in the operating room. This article aims to explain and describe the latest modality of IONM, its basic concept and its function at surgery. The last part of the article discussed about orthopaedic surgical techniques which use IONM. The authors hope that this article will enhance the knowledge of all the readers about IONM. This article was written based on literature study searched at Google Scholar, Medline and PubMed. The references were taken from a relatively up to date study ranging from 2013-2018. The article was selected according to the authors inclusion criteria and six articles was chosen as the references for this review. As a conclusion, IONM has an important role to increase successful rate of surgery through minimizing nerve injury risk during surgical procedure.

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Complications and Pitfalls in Maxillofacial Trauma

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1108 ◽

2014 ◽

Vol 48 (2) ◽

pp. 91-97

Author(s):

Vidya Rattan ◽

Sachin Rai ◽

Shikha Yadav

Keyword(s):

Treatment Failure ◽

Surgical Procedure ◽

Treatment Plan ◽

Surgical Techniques ◽

Maxillofacial Trauma ◽

Trauma Surgeon ◽

Form And Function ◽

Fixation Devices ◽

And Function ◽

Made In

ABSTRACT Complications and pitfalls are unavoidable sequel of any surgical procedure. Although advances have been made in surgical techniques and fixation devices, these are far from ideal. The aim of trauma surgeon is to restore the patient to pre-injury form and function, but it may not be possible in each and every case. Treatment failure and poor outcome in a case of severe maxillofacial trauma is not uncommon. This is mainly dependent upon the extent of injury, delay in management, improper diagnosis, wrong treatment plan, poor execution of a treatment plan, wrong choice of fixation devices, inexperience of the surgeon and inability to seek help from other specialists, etc. The objective of this article is to discuss and analyze common complications and pitfalls along with the various methods and modalities to prevent and manage it. How to cite this article Rattan V, Rai S, Yadav S. Complications and Pitfalls in Maxillofacial Trauma. J Postgrad Med Edu Res 2014;48(2):91-97.

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Abstract No. 197 Using intraoperative neurophysiologic monitoring to prevent peripheral nerve injury during embolization of low-flow vascular malformations

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2021.03.203 ◽

2021 ◽

Vol 32 (5) ◽

pp. S86-S87

Author(s):

F. Yuan ◽

A. Gong ◽

A. Farhan ◽

P. Gowda ◽

C. Bailey ◽

...

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Vascular Malformations ◽

Low Flow ◽

Neurophysiologic Monitoring ◽

Intraoperative Neurophysiologic Monitoring

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Neurophysiological Monitoring During Large Femoral and Pelvic Tumoral Resections

10.31487/j.jscr.2020.01.02 ◽

2020 ◽

pp. 1-5

Author(s):

Camilla Arvinius ◽

Elena Manrique-Gamo ◽

Hector Marcelo ◽

Juan-Luis Cebrian ◽

...

Keyword(s):

Sciatic Nerve ◽

Evoked Potentials ◽

Nerve Injury ◽

Neurological Injury ◽

Neurophysiological Monitoring ◽

Case Presentation ◽

Neurophysiologic Monitoring ◽

Intraoperative Neurophysiologic Monitoring ◽

Postoperative Control ◽

A Prospective Study

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 complications

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