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https://www.readbyqxmd.com/read/28078360/multimodal-nerve-monitoring-during-periacetabular-osteotomy-identifies-surgical-steps-associated-with-risk-of-injury
#1
Eduardo N Novais, Travis Heare, Lauryn Kestel, Patricia Oliver, Willy Boucharel, Jason Koerner, Kim Strupp
PURPOSE: Sciatic nerve palsy after periacetabular osteotomy (PAO) is a serious complication. The purpose of this study was to determine whether a multimodal sciatic monitoring technique allows for identification of surgical steps that place the sciatic nerve at risk. METHODS: Transcranial electrical motor evoked potentials (TcMEPs), somatosensory evoked potentials (SSEPs), and spontaneous electromyography (EMG) were monitored in a consecutive series of 34 patients (40 hips) who underwent PAO for the treatment of symptomatic hip dysplasia between January 2012 and November 2014...
January 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28058473/brain-oxygenation-during-thoracoscopic-repair-of-long-gap-esophageal-atresia
#2
Lisanne J Stolwijk, David C van der Zee, Stefaan Tytgat, Desiree van der Werff, Manon J N L Benders, Maud Y A van Herwaarden, Petra M A Lemmers
BACKGROUND: Elongation and repair of long gap esophageal atresia (LGEA) can be performed thoracoscopically, even directly after birth. The effect of thoracoscopic CO2-insufflation on cerebral oxygenation (rScO2) during the consecutive thoracoscopic procedures in repair of LGEA was evaluated. METHODS: Prospective case series of five infants, with in total 16 repetitive thoracoscopic procedures. A CO2-pneumothorax was installed with a pressure of maximum 5 mmHg and flow of 1 L/min...
January 5, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28045853/intraoperative-neuromonitoring-and-alarm-criteria-for-judging-mep-responses-to-transcranial-electric-stimulation-the-threshold-level-method
#3
Blair Calancie
The motor evoked potential (MEP) is used in the operating room to gauge-and ultimately protect-the functional integrity of the corticospinal tract (CST). However, there is no consensus as to how to best interpret the MEP for maximizing its sensitivity and specificity to CST compromise. The most common way is to use criteria associated with response magnitude (response amplitude; waveform complexity, etc.). With this approach, should an MEP in response to a fixed stimulus intensity diminish below some predetermined cutoff, suggesting CST dysfunction, then the surgical team is warned...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28035477/contribution-of-intraoperative-neural-monitoring-to-preservation-of-the-external-branch-of-the-superior-laryngeal-nerve-a-randomized-prospective-clinical-trial
#4
Mehmet Uludag, Nurcihan Aygun, Kinyas Kartal, Bulent Citgez, Evren Besler, Gurkan Yetkin, Cemal Kaya, Hamdi Ozsahin, Mehmet Mihmanli, Adnan Isgor
PURPOSE: The purpose of this study was to evaluate the effect of intraoperative neuromonitoring (IONM) on the injury rate of the external branch of the superior laryngeal nerve (EBSLN) during thyroidectomy. METHODS: A total of 133 consenting patients (98 female, 35 male; mean age, 45.6 ± 11.7 years) undergoing thyroidectomy were randomly assigned to 2 groups. In group 1 (n = 65 patients, 105 nerves), superior thyroid pole dissection was performed with no attempt to identify the EBSLN; in group 2 (n = 68 patients, 106 nerves), IONM was used to identify the EBSLN during surgery...
December 29, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28034706/vagal-and-recurrent-laryngeal-nerves-neuromonitoring-during-thyroidectomy-and-parathyroidectomy-a-prospective-study
#5
N Julien, E Ferrary, A Sokoloff, G Lamas, O Sterkers, D Bernadeschi
OBJECTIVES: The aim of the study was to stimulate the vagal and the recurrent laryngeal nerves during and after thyroidectomy or parathyroidectomy, to record muscle responses, interpret the electrophysiological modifications and identify prognostic factors for postoperative vocal fold mobility. PATIENTS AND METHODS: A prospective study monitored 151 vagal nerves and 144 recurrent laryngeal nerves in 114 patients. Seven patients (14 vagal nerves) underwent continuous monitoring via an automatic periodic stimulation (APS(®)) electrode...
December 26, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28018768/rare-intradural-cervical-nerve-root-metastasis-of-follicular-thyroid-carcinoma
#6
Joseph Keen, Elena Milosavljevic, George Hanna, Vadim Gospodarev, Ravi Raghavan, Samer Ghostine
Intradural extramedullary nerve root metastasis is extremely unusual with only a handful of cases reported, and it presents most commonly in the thoracic and lumbosacral regions. We report the first case of metastasis to a ventral cervical nerve root in a patient with low-grade follicular thyroid carcinoma thought to be in remission for several years. Histopathology demonstrated malignant transformation and invasion of the nerve root. This case underscores that any history of malignancy regardless of staging, grading, or remission status should raise the suspicion of metastasis as it can mimic other spine and nerve sheath tumors and represent malignant transformation...
November 24, 2016: Curēus
https://www.readbyqxmd.com/read/28004334/noninvasive-neuromonitoring-current-utility-in-subarachnoid-hemorrhage-traumatic-brain-injury-and-stroke
#7
Luisa Vinciguerra, Julian Bösel
Noninvasive neuromonitoring is increasingly being used to monitor the course of primary brain injury and limit secondary brain damage of patients in the neurocritical care unit. Proposed advantages over invasive neuromonitoring methods include a lower risk of infection and bleeding, no need for surgical installation, mobility and portability of some devices, and safety. The question, however, is whether noninvasive neuromonitoring is practical and trustworthy enough already. We searched the recent literature and reviewed English-language studies on noninvasive neuromonitoring in subarachnoid hemorrhage, traumatic brain injury, and ischemic and hemorrhagic stroke between the years 2010 and 2015...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27999623/personalized-approach-in-brain-protection-by-hypothermia-individual-changes-in-non-pathological-and-ischemia-related-glutamate-transport-in-brain-nerve-terminals
#8
Artem Pastukhov, Natalia Krisanova, Vitalii Maksymenko, Tatiana Borisova
BACKGROUND: Both deep and profound hypothermia are effectively applied in cardiac surgery of the aortic arch, when the reduction of cerebral circulation facilitates operations, and for the prevention of ischemic stroke consequences. Neurochemical discrimination of the effects of deep and profound hypothermia (27 and 17 °C, respectively) on non-pathological and pathological ischemia-related mechanisms of presynaptic glutamate transport with its potential contribution to predictive, preventive and personalized medicine (PPPM) was performed...
2016: EPMA Journal
https://www.readbyqxmd.com/read/27989608/is-intraoperative-neural-monitoring-necessary-for-exploration-of-the-superior-laryngeal-nerve
#9
Mehmet Uludag, Nurcihan Aygun, Kinyas Kartal, Evren Besler, Adnan Isgor
BACKGROUND: We aimed to evaluate the contribution of intraoperative neuromonitoring to the visual and functional identification of the external branch of the superior laryngeal nerve and the effect on postoperative voice changes. METHODS: The prospective data of 221 patients (183 women, 38 men) who underwent thyroid operation with intraoperative neuromonitoring for exploration of the external branch of the superior laryngeal nerve were evaluated retrospectively...
December 15, 2016: Surgery
https://www.readbyqxmd.com/read/27988880/posterior-hemivertebrectomy-and-short-segment-fixation-long-term-results
#10
Saumyajit Basu, Agnivesh Tikoo
OBJECTIVES: The objectives of this study were to study the long-term results of one-stage single and multiple level posterior hemivertebrectomies and to find out the safety and efficacy of the procedure. METHOD: Twenty patients (9 male and 11 female) with mean age of 9.2 years (2 years 4 months-14 years 10 months) with congenital scoliosis (hemivertebrae) were treated with posterior hemivertebrectomy with intraoperative neuromonitoring. Posterior exposure and transpedicular fixation of the adjoining vertebrae was done...
December 17, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27955847/-intraoperative-neuromonitoring-in-thyroid-surgery
#11
José Jacob Motos-Micó, Manuel Felices-Montes, Teresa Abad-Aguilar
BACKGROUND: Intraoperative neuromonitoring of the recurrent laryngeal nerve in thyroid surgery facilitates the identification of anatomical structures in cervical endocrine surgery reducing the frequency of vocal cord paralysis. OBJECTIVE: To study the normal electrophysiological values of the vague and recurrent laryngeal nerves before and after thyroid surgery. To compare rates of injury of recurrent nerve before and after the introduction of the intraoperative neuromonitoring in thyroid surgery...
December 9, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27943228/history-of-spine-deformity-in-turkey
#12
Sait Naderi, Gülten Dinç
Spine deformities are among the most important spinal disorders, affecting health related life quality. Although, there are some studies in past centuries, most of spine deformity related studies and researches started in last century. Many surgical techniques, performed between 1960 and 1990, made scoliosis a touchable pathology. These techniques started with Harrington\'s system, wiring techniques, pedicle screw techniques, and all other universal techniques. Anterior and 360 degree techniques contributed to this process...
November 15, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27923761/intraoperative-neurophysiological-monitoring-for-adult-patients-undergoing-posterior-spinal-fusion
#13
Nitin Agarwal, D Kojo Hamilton, Alp Ozpinar, Phillip Choi, Robert Hart, Ilker Yaylali
INTRODUCTION: Somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP) are frequently used to monitor neurological function during spinal deformity surgery. The sensitivity and specificity of intraoperative neurophysiological monitoring (IONM) in patients undergoing posterior spinal fusion (PSF) in debatable. METHODS: A retrospective review of all patients undergoing PSF with IONM from October 2008 to December 2012 was performed. Factors including gender, operative time and spinal levels of posterior fusion were analyzed as risk factors for intraoperative alerts...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27922259/development-of-neurocritical-care-enhanced-neuromonitoring-or-better-specialists-cooperation
#14
Nicolas Bruder, Salah Boussen, Lionel Velly
No abstract text is available yet for this article.
December 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27907953/management-of-the-pediatric-neurocritical-care-patient
#15
Christopher M Horvat, Haifa Mtaweh, Michael J Bell
Pediatric neurocritical care is a growing subspecialty of pediatric intensive care that focuses on the management of acute neurological diseases in children. A brief history of the field of pediatric neurocritical care is provided. Neuromonitoring strategies for children are reviewed. Management of major categories of acute childhood central neurologic diseases are reviewed, including treatment of diseases associated with intracranial hypertension, seizures and status epilepticus, stroke, central nervous system infection and inflammation, and hypoxic-ischemic injury...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27867862/intermittent-neural-monitoring-of-the-recurrent-laryngeal-nerve-in-surgery-for-recurrent-goiter
#16
REVIEW
Beata Wojtczak, Marcin Barczyński
Reoperative thyroid surgery is still challenging even for skilled surgeons, and is associated with a higher incidence of complications, such as hypoparathyroidism and recurrent laryngeal nerve (RLN) palsy. Displacement of the RLN, scar tissue from previous neck surgery and difficulty in maintaining good hemostasis are risk factors in reoperations. The prevalence of RLN injury in reoperative thyroid surgery ranges as high as 12.5% for transient injury and up to 3.8% for permanent injury. Bilateral paresis can also occur during reoperations, and is a dangerous complication influencing the quality of life, sometimes requiring tracheostomy...
October 2016: Gland Surgery
https://www.readbyqxmd.com/read/27861939/changes-in-electromyographic-amplitudes-but-not-latencies-occur-with-endotracheal-tube-malpositioning-during-intraoperative-monitoring-for-thyroid-surgery-implications-for-guidelines
#17
Samuel R Barber, Whitney Liddy, Natalia Kyriazidis, Matteo Cinquepalmi, Brian M Lin, Rahul Modi, Stephanie Patricio, Dipti Kamani, Carlo Belotti, Sadhana Mahamad, Bradley Lawson, Gregory W Randolph
OBJECTIVES/HYPOTHESIS: During intraoperative neural monitoring (IONM) in thyroid and parathyroid surgery, endotracheal (ET) tube migration can result in a decrease in vocalis electromyographic (EMG) amplitude without a concordant latency elevation during stimulation of the recurrent laryngeal nerve (RLN). STUDY DESIGN: Retrospective review. METHODS: Data were reviewed retrospectively for thyroid and parathyroid surgery patients with IONM of the laryngeal nerves from January 2015 to December 2015...
November 16, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27861447/diagnostic-accuracy-of-neuromonitoring-for-identification-of-new-neurologic-deficits-in-pediatric-spinal-fusion-surgery
#18
Victor M Neira, Kamyar Ghaffari, Srinivas Bulusu, Paul J Moroz, James G Jarvis, Nicholas Barrowman, William Splinter
BACKGROUND: Intraoperative neuromonitoring (IONM) modalities, transcranial motor-evoked potentials (TcMEPs), and somatosensory-evoked potentials (SSEPs) are accepted methods to identify impending spinal cord injury during spinal fusion surgery. Debate exists over sensitivity and specificity of these modalities. Our purpose was to measure the incidence of new neurologic deficits (NNDs) and estimate sensitivity and specificity of IONM modalities. METHODS: Institutional Ethics Board approval was obtained to review charts of patients younger than 22 years undergoing scoliosis surgery from 2007 to 2014 retrospectively...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27858240/return-of-motor-evoked-potentials-after-knee-flexion-in-the-setting-of-high-grade-spondylolisthesis
#19
Justin Tilan, Lindsay M Andras, Mark D Krieger, David L Skaggs
PURPOSE: To present a case of loss of motor-evoked potentials (MEPs) to the left foot in the supine position after a partial reduction and instrumented fusion from L4 to pelvis which was managed successfully without revision or removal of implants. METHODS: We report a patient with high-grade spondylolisthesis who demonstrated loss of motor-evoked potentials after posterior spinal fusion and transfer to supine position. The patient's knees were flexed to 90° and signals were immediately restored...
November 17, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27852500/cost-effectiveness-of-lumbar-spondylolisthesis-surgery-at-2-year-follow-up
#20
Charla R Fischer, Ryan Cassilly, Marc Dyrszka, Yuriy Trimba, Austin Peters, Jeffrey A Goldstein, Jeffrey Spivak, John A Bendo
OBJECTIVES: The purpose of this study was to determine the cost/quality-adjusted life-year (QALY) of the operative treatment of lumbar spondylolisthesis and identify factors associated with cost-effectiveness at 2 years. METHODS: We evaluated patients who underwent surgery for spondylolisthesis. The QALY was determined from the EQ5D. Outcomes were also assessed using the Oswestry Disability Index (ODI). Surgical, neuromonitoring, and anesthesia Current Procedural Terminology (CPT) codes as well as hospital Diagnosis-Related Group codes were used to determine the Medicare direct care costs of surgery...
January 2016: Spine Deformity
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