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https://www.readbyqxmd.com/read/27923761/intraoperative-neurophysiological-monitoring-for-adult-patients-undergoing-posterior-spinal-fusion
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27851660/the-utility-of-intraoperative-neuromonitoring-for-lumbar-pedicle-screw-placement-is-questionable-a-review-of-9957-cases
#9
Remi M Ajiboye, Stephen D Zoller, Anthony D'Oro, Zachary D Burke, William Sheppard, Christopher Wang, Zorica Buser, Jeffrey C Wang, Sina Pourtaheri
STUDY DESIGN: Retrospective database study OBJECTIVE.: The goal of this study was to 1). Evaluate the trends in the use of electromyography (EMG) for instrumented posterolateral lumbar fusions (PLFs) in the United States and 2). Assess the risk of neurological injury following PLFs with and without EMG. SUMMARY OF BACKGROUND DATA: Neurologic injuries from iatrogenic pedicle wall breaches during screw placement are known complications of PLFs. The routine use of intraoperative neuromonitoring (ION) such as EMG during PLF to improve the accuracy and safety of pedicle screw implantation remains controversial...
November 15, 2016: Spine
https://www.readbyqxmd.com/read/27846184/minimal-endoscope-assisted-thyroidectomy-through-a-retroauricular-approach-an-evolving-solo-surgery-technique
#10
Myung Jin Ban, Jae Won Chang, Won Shik Kim, Hyung Kwon Byeon, Yoon Woo Koh, Jae Hong Park
This study aimed to evaluate the feasibility and efficacy of minimal endoscope-assisted thyroidectomy (MEAT) through a retroauricular (RA) approach. Most of the thyroidectomy operative time was accounted for by direct visualization through the RA window, minimizing interference between surgical instruments. Endoscope use was minimized and limited to critical surgical aspects, including preservation of the recurrent laryngeal nerve and parathyroid glands. The recurrent laryngeal nerve was neuromonitored throughout the procedure...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27837190/hyperoxia-results-in-increased-aerobic-metabolism-following-acute-brain-injury
#11
Arnab Ghosh, David Highton, Christina Kolyva, Ilias Tachtsidis, Clare E Elwell, Martin Smith
Acute brain injury is associated with depressed aerobic metabolism. Below a critical mitochondrial pO2 cytochrome c oxidase, the terminal electron acceptor in the mitochondrial respiratory chain, fails to sustain oxidative phosphorylation. After acute brain injury, this ischaemic threshold might be shifted into apparently normal levels of tissue oxygenation. We investigated the oxygen dependency of aerobic metabolism in 16 acutely brain-injured patients using a 120-min normobaric hyperoxia challenge in the acute phase (24-72 h) post-injury and multimodal neuromonitoring, including transcranial Doppler ultrasound-measured cerebral blood flow velocity, cerebral microdialysis-derived lactate-pyruvate ratio (LPR), brain tissue pO2 (pbrO2), and tissue oxygenation index and cytochrome c oxidase oxidation state (oxCCO) measured using broadband spectroscopy...
November 11, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27819021/nonrecurrent-laryngeal-nerve-in-the-era-of-intraoperative-nerve-monitoring
#12
Emin Gurleyik, Gunay Gurleyik
Nonrecurrent laryngeal nerve (non-RLN) is an anatomical variation increasing the risk of vocal cord palsy. Prediction and early identification of non-RLN may minimize such a risk of injury. This study assessed the effect of intraoperative neuromonitoring (IONM) on the detection of non-RLN. A total of 462 (236 right) nerves in 272 patients were identified and totally exposed, and all intraoperative steps of IONM were sequentially applied on the vagus nerve (VN) and RLN. Right predissection VN stimulation at a distal point did not create a sound signal in three cases (3/236; 1...
2016: Advances in Medicine
https://www.readbyqxmd.com/read/27812786/the-functional-role-of-the-pharyngeal-plexus-in-vocal-cord-innervation-in-humans
#13
Mehmet Uludag, Nurcihan Aygun, Adnan Isgor
Classical understanding of the function of the pharyngeal plexus in humans is that it relies on both motor branches for innervation of the majority of pharyngeal muscles and sensory branches for the pharyngeal wall sensation. To date there has been no reported data on the role of the pharyngeal plexus in vocal cord innervation. The aim of this study is to evaluate whether or not the plexus pharyngeus contributes to the innervation of the vocal cords. One hundred twenty-five sides from 79 patients (59 female, 20 male) undergoing thyroid surgery with intraoperative neuromonitoring were prospectively evaluated...
November 3, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27811493/failed-vocalis-muscle-monitoring-during-thyroid-surgery-resulting-from-residual-muscle-relaxation
#14
Marie-Luise Ruebsam, Christian Hoenemann
Postoperative paralysis of the vocal cords resulting from intraoperative surgical injury of the recurrent laryngeal nerve is one of the most serious complications of elective thyroid surgery. The chance of injury is reduced by using intraoperative neuromonitoring (IONM). This educational report describes a case of IONM failure resulting from residual muscle relaxation that was restored by administration of sugammadex. It discusses possible pharmacology explanations and provides recommendations for how to prevent this situation in daily practice...
November 2, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27792108/efficacy-of-intraoperative-neurophysiologic-monitoring-for-pediatric-cervical-spine-surgery
#15
Daniel G Tobert, Michael P Glotzbecker, M Timothy Hresko, Lawrence I Karlin, Mark R Proctor, John B Emans, Patricia E Miller, Daniel J Hedequist
STUDY DESIGN: Clinical case series OBJECTIVE.: To investigate the efficacy of intraoperative neuromonitoring in pediatric cervical spine surgery SUMMARY OF BACKGROUND DATA.: Intraoperative neuromonitoring (IONM) consisting of somatosensory evoked potentials (SSEP) and transcranial motor evoked potentials (tcMEP) has been shown to effectively prevent permaneny neurologic injury in deformity surgery. The role of IONM during pediatric cervical spine surgery is not well documented. Advances in cervical spine instrumentation have expanded the surgical options in pediatric populations...
October 25, 2016: Spine
https://www.readbyqxmd.com/read/27755164/an-update-on-the-status-of-nerve-monitoring-for-thyroid-parathyroid-surgery
#16
Ho-Sheng Lin, David J Terris
PURPOSE OF REVIEW: Recurrent laryngeal nerve (RLN) injury is one of the most common and serious complications associated with thyroid and parathyroid surgery. Although routine visual identification of the RLN is considered the current standard of care, the role of intraoperative neuromonitoring (IONM) of the RLN is more controversial. RECENT FINDINGS: Despite initial enthusiasm that IONM might substantially reduce the rate of RLN injury, most studies failed to show a significant difference in the rate of RLN injury when the use of IONM was compared with visualization of the RLN alone...
January 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/27751929/intraoperative-loss-of-tibialis-anterior-tcemep-predicted-postoperative-foot-drop-a-case-report
#17
Qing Yue, Tyson Hale, Aaron Knecht, Jennifer Laidacker
BACKGROUND: Foot drop secondary to L5 root injury is a rare complication associated with lumbar surgery. To date, it is still not clear whether intraoperative neuromonitoring can detect such an injury. CASE DESCRIPTION: A 54-year-old man who had had bilateral chronic L5 radiculopathy underwent L4-S1 lumbosacral decompression and fusion. During the surgery, the patient lose transcranial electrical motor evoked potential (tceMEPs) from left tibialis anterior (TA) at the time of L5-S1 intervertebral cage placement...
October 14, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27733184/what-is-the-value-of-regional-cerebral-saturation-in-post-cardiac-arrest-patients-a-prospective-observational-study
#18
Cornelia Genbrugge, Ward Eertmans, Ingrid Meex, Margaretha Van Kerrebroeck, Noami Daems, An Creemers, Frank Jans, Willem Boer, Jo Dens, Cathy De Deyne
BACKGROUND: The aim of this study was to elucidate the possible role of cerebral saturation monitoring in the post-cardiac arrest setting. METHODS: Cerebral tissue saturation (SctO2) was measured in 107 successfully resuscitated out-of-hospital cardiac arrest patients for 48 hours between 2011 and 2015. All patients were treated with targeted temperature management, 24 hours at 33 °C and rewarming at 0.3 °C per hour. A threshold analysis was performed as well as a linear mixed models analysis for continuous SctO2 data to compare the relation between SctO2 and favorable (cerebral performance category (CPC) 1-2) and unfavorable outcome (CPC 3-4-5) at 180 days post-cardiac arrest in OHCA patients...
October 13, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27727054/axillary-nerve-lesions-after-open-reduction-and-internal-fixation-of-proximal-humeral-fractures-through-an-extended-lateral-deltoid-split-approach-electrophysiological-findings
#19
Thomas Westphal, Stephan Woischnik, Daniela Adolf, Helmut Feistner, Stefan Piatek
BACKGROUND: Axillary nerve injuries after shoulder surgery are rare. In most studies, the frequency of injury is usually determined using clinical examinations, but results from intraoperative neuromonitoring studies have revealed higher than expected rates. Few studies have investigated this topic. Our aim was to determine the frequency of axillary nerve lesions after open reduction and internal fixation of proximal humeral fractures by using electrophysiological assessments and to provide a review of the relevant literature...
October 7, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27720825/importance-of-latency-and-amplitude-values-of-recurrent-laryngeal-nerve-during-thyroidectomy-in-diabetic-patients
#20
Ibrahim Ali Ozemir, Ferman Ozyalvac, Gorkem Yildiz, Tunc Eren, Zeynep Aydin-Ozemir, Orhan Alimoglu
BACKGROUND: Diabetes mellitus may cause degeneration in the myelin and/or axonal structures of peripheral nerves. The aim of this study was to investigate the effects of diabetic neuropathy on intraoperative neuromonitoring findings such as latency and amplitude values of the recurrent laryngeal nerves during thyroidectomy. To our knowledge this is the first study to report comparison of the electrophysiologic features of diabetic and non-diabetic patients. MATERIALS AND METHODS: One-hundred-and-eleven consecutive patients who received neuromonitoring during thyroidectomy between 2013 and 2015 were included to study...
October 5, 2016: International Journal of Surgery
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