scholarly journals Use of intraoperative neurophysiological monitoring in surgical treatment of spinal diseases

2019 ◽  
Vol 147 (7-8) ◽  
pp. 502-505
Author(s):  
Vedrana Karan ◽  
Djula Djilvesi ◽  
Mladen Karan ◽  
Vladimir Papic ◽  
Petar Vulekovic
Keyword(s):  
Spinal Cord ◽  
Surgical Procedures ◽  
Neurological Complications ◽  
Neurological Deficits ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Spinal Diseases ◽  
Optimal Monitoring ◽  
Methods Development ◽  
Care Costs

Intraoperative neurophysiological monitoring (IONM) is a method, which uses different kinds of electrophysiological methods for monitoring and mapping of neural structures during surgical procedures with the aim to preserve them. If we know how important the function of the spine, spinal cord, nerve roots, and all other structures are, it is obvious how important it is to preserve them in surgical procedures where these structures are under risk. Although the frequency of neurological complications is not high, it is considered that these deficits are devastating complications of spinal surgery, which can have serious consequences on the quality of life and can increase health care costs. Because of that, the accent is on intraoperative neurophysiological methods development, which provide optimal monitoring of the spinal cord function during routine and complex spinal procedures and has high efficacy detecting possible neurological deficits. The concept of multimodal neuromonitoring, which is used today, relies on advantages of each modality separately and then in combination of these modalities it achieves a more reliable estimation of functional integrity. Today IONM is routinely used worldwide, but in Serbia, its use is still limited even though its advantages are well known.

Transvertebral Transposition of the Spinal Cord for Recovery of Motor Evoked Potentials and Somatosensory Evoked Potentials After Acute Paraplegia During Kyphoscoliosis Surgery: Technique Note, Case Reports and Literature Review

2020 ◽  
Author(s):  
Chao Chen ◽  
Jing Li ◽  
Bingjin Wang ◽  
Lingwei Zhu ◽  
Yong Gao ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Motor Evoked Potentials ◽  
Case Reports ◽  
Deformity Correction ◽  
Neurological Deficits ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Acute Paraplegia

Abstract Background: Neurological impairment during spinal deformity surgery was the most serious complication. When confronting intraoperative neurophysiological monitoring alerts, various surgical management methods such as the release of implants and decompression of the spinal cord are always performed. Transvertebral transposition of the spinal cord is rarely performed, and its role in the management of acute paraplegia is seldom reported.Methods: The authors present two patients with kyphoscoliosis experienced intraoperatively or postoperatively neurological deficits and abnormal neurological monitoring was detected during correction surgery. Acute paraplegia was confirmed by a wake-up test. Subsequent spinal cord transposition was performed. Intraoperative neurophysiological monitoring motor evoked potentials (MEP) and somatosensory evoked potentials (SEP) was performed to detect the changes during the process.Results: After transvertebral transposition of the spinal cord, the MEPs and SEPs were significantly improved in both patients during surgery. The spinal cord function was restored postoperatively and recovered to normal at the final follow-up in two patients. Conclusions： This case demonstrated that instead of decreasing the correction ratio of kyphoscoliosis, transvertebral transposition of the spinal cord under intraoperative neurophysiological monitoring could be an effective therapeutic strategy for acute spinal cord dysfunction caused by deformity correction surgeries.

Diagnostic Utility of Intraoperative Neurophysiological Monitoring for Intramedullary Spinal Cord Tumors

2018 ◽  
Vol 31 (3) ◽  
pp. 112-119 ◽  
Author(s):  
Tej D. Azad ◽  
Arjun V. Pendharkar ◽  
Viet Nguyen ◽  
James Pan ◽  
Ian D. Connolly ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Diagnostic Utility ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord

scholarly journals Intra-operative neurophysiological monitoring

2015 ◽  
Vol 02 (03) ◽  
pp. 179-192
Author(s):  
Zulfiqar Ali ◽  
Parmod Bithal
Keyword(s):  
Evoked Potentials ◽  
Surgical Procedures ◽  
Complication Rate ◽  
Motor Evoked Potentials ◽  
Neurological Complication ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Sensory Evoked Potentials ◽  
Sensory Evoked

AbstractIntraoperative neurophysiological monitoring has achieved importance due to complexity of cranio-spinal surgical procedures being performed frequently these days. Many studies have proven a decreased neurological complication rate after its introduction. It is broadly of two types: Sensory evoked potentials and motor evoked potentials which are further sub-divided. Its use during surgery requires a controlled anaesthesia technique with no or minimal influence on its recording. Its success depends upon three way communication among the surgeon the neurophysiologist and the anaesthesiologist.

Intraoperative neurophysiological monitoring in patients undergoing tethered cord surgery after fetal myelomeningocele repair

2014 ◽  
Vol 13 (4) ◽  
pp. 355-361 ◽  
Author(s):  
Eric M. Jackson ◽  
Daniel M. Schwartz ◽  
Anthony K. Sestokas ◽  
Deborah M. Zarnow ◽  
N. Scott Adzick ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Motor Evoked Potential ◽  
Tethered Cord ◽  
Neurological Status ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Neural Function ◽  
Lower Extremity Function ◽  
Fetal Repair ◽  
Myelomeningocele Repair

Object Fetal myelomeningocele closure has been shown to be advantageous in a number of areas. In this study, the authors report on neural function in patients who had previously undergone fetal myelomeningocele repair and returned to the authors' institution for further surgery that included intraoperative neurophysiological monitoring. Methods The authors retrospectively reviewed data obtained in 6 cases involving patients who underwent fetal myelomeningocele repair and later returned to their institution for spinal cord untethering. (In 4 of the 6 cases, the patients also underwent removal of a dermoid cyst [3 cases] or removal of an epidermoid cyst [1 case] during the untethering procedure.) Records and imaging studies were reviewed to identify the anatomical level of the myelomeningocele as well as the functional status of each patient. Stimulated electromyography (EMG) and transcranial motor evoked potential (tcMEP) recordings obtained during surgery were reviewed to assess the functional integrity of the nerve roots and spinal cord. Results During reexploration, all patients had reproducible signals at or below their anatomical level on stimulated EMG and tcMEP recordings. Corresponding to these findings, prior to tethering, all patients had antigravity muscle function below their anatomical level. Conclusions All 6 patients had lower-extremity function and neurophysiological monitoring recording signals at or below their anatomical level. These cases provide direct evidence of spinal cord and nerve root conductivity and functionality below the anatomical level of the myelomeningocele, further supporting that neurological status improves with fetal repair.

Spinal Cord Tumor Surgery—Importance of Continuous Intraoperative Neurophysiological Monitoring After Tumor Resection

Spine ◽  
2012 ◽  
Vol 37 (16) ◽  
pp. E1001-E1008 ◽  
Author(s):  
Marie-Thérèse Forster ◽  
Gerhard Marquardt ◽  
Volker Seifert ◽  
Andrea Szelényi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Intraoperative Neurophysiological Monitoring ◽  
Neurophysiological Monitoring ◽  
Tumor Surgery
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