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Neurophysiology intraoperative monitoring

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https://www.readbyqxmd.com/read/29452324/microsurgical-clipping-of-intracranial-aneurysms-assisted-by-neurophysiological-monitoring-microvascular-flow-probe-and-icg-va-outcomes-and-intraoperative-data-on-a-multimodal-strategy
#1
Alessandro Della Puppa, Marta Rossetto, Francesco Volpin, Oriela Rustemi, Alberto Grego, Alessandra Gherardi, Riccardo Ortolan, Francesco Causin, Marina Munari, Renato Scienza
OBJECTVE: The aim of this study is to report data on a multimodal monitoring strategy based on the intraoperative use of neurophysiological monitoring, flowmetry by microflow probe and intraoperative indocyanine green-videoangiography (ICG-VA) during microsurgical clipping of intracranial aneurysms. METHODS: This retrospective analysis was performed on 85 consecutive patients undergoing clipping of 96 intracranial aneurysms with the present monitoring strategy. Patient outcomes were evaluated by assessing rate of aneurysm exclusion and post-operative occurrence of ischemic injury...
February 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29408593/acute-compartment-syndrome-as-a-complication-of-the-use-of-intraoperative-neuromonitoring-needle-electrodes
#2
Ilyas M Eli, Nicholas T Gamboa, Jian Guan, Philipp Taussky
BACKGROUND: The use of intraoperative neurophysiologic monitoring (IOM) has become commonplace in many neurosurgical procedures as a tool to reduce the risk of complications through the early identification of reversible neurologic compromise. Although complications related to IOM itself are exceedingly rare, recognizing their clinical presentation in the postoperative neurosurgical patient is essential for the early identification and implementation of appropriate treatment. CASE DESCRIPTION: The authors present a case report of a patient who developed postoperative acute compartment syndrome in the right arm after placement of neuromonitoring needles for routine IOM during endovascular treatment of a left internal carotid artery aneurysm...
February 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29375947/the-impact-of-neurophysiological-intraoperative-monitoring-during-spinal-cord-and-spine-surgery-a-critical-analysis-of-121-cases
#3
Tarik Ibrahim, Oliver Mrowczynski, Omar Zalatimo, Vernon Chinchilli, Jonas Sheehan, Robert Harbaugh, Elias Rizk
Neuromonitoring has been utilized during spinal surgery to assess the function of the spinal cord in an effort to prevent intraoperative injury. Although its use is widespread, no clear benefit has been demonstrated. Our goal in this study was to interrogate the value of intraoperative neuromonitoring in decreasing the severity and rate of neurological injury during and after spinal surgery. Here we describe our experience of 121 patients who underwent spinal cord procedures with the combination of intraoperative neuromonitoring, to determine its ability to detect neurological changes and the specificity and sensitivity in this setting...
November 19, 2017: Curēus
https://www.readbyqxmd.com/read/29373396/clinical-neurophysiology-training-in-a-developing-country-institutional-resources-and-profiles
#4
Arturo G Sámano, José D Ochoa Mena, Silvana P Padilla, Gerardo R Acevedo, José M Orenday Barraza, Daniel San-Juan
PURPOSE: The purpose of this study was to describe the characteristics and preferences of clinical neurophysiology (CN) fellows, as well as the resources available for their training, in a developing country such as Mexico. METHODS: An online survey (25 questions) was given to Mexican CN fellows from May to June 2017, covering their reasons for choosing the CN subspecialty, their activities, future plans, institutional resources, and administrative staff. Descriptive statistics were used...
January 23, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29361259/the-establishment-of-an-anaesthetist-managed-intraoperative-neurophysiological-monitoring-service-and-initial-outcome-data
#5
B L Olesnicky, R J D'Souza, D Jayram, Omo Kim, A Rehak
Neurophysiological monitoring has been recommended to reduce the risk of neurological damage during a wide variety of surgeries. While the concept of an anaesthesia-led intraoperative neurophysiological monitoring (IONM) service is not new, the quality of this service provision has not been studied. In this article, we present our experience with the establishment of this service, and the results of our audit of 302 cases monitored over the initial four years. Our results identified that an anaesthesia-led IONM service was able to achieve a reliable signal in 95...
January 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29334639/vestibular-schwannoma-and-hearing-preservation-usefulness-of-level-specific-ce-chirp-abr-monitoring-a-retrospective-study-on-25-cases-with-preoperative-socially-useful-hearing
#6
Luciano Mastronardi, Ettore Di Scipio, Guglielmo Cacciotti, Raffaelino Roperto
BACKGROUND AND OBJECTIVES: Decision-making regarding the therapy of vestibular schwannoma (VS) changed over the last decades, during which curative microsurgery has been promoted. Goals of VS microsurgery are: extensive resection, facial nerve (FN) preservation and, in selected cases, hearing preservation (HP). The aim of this study is to evaluate postoperative HP with reference to tumor size in patients operated on with Level Specific (LS)-CE-Chirp® ABR monitoring. PATIENTS AND METHODS: Twentyfive consecutive patients with socially useful hearing (SUH) underwent VS microneurosurgery by retrosigmoid (RS) approach...
February 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29313181/intraoperative-neurophysiological-monitoring-during-spinal-surgery-technical-review-in-open-and-minimally-invasive-approaches
#7
REVIEW
Fabio Cofano, Francesco Zenga, Marco Mammi, Roberto Altieri, Nicola Marengo, Marco Ajello, Paolo Pacca, Antonio Melcarne, Carola Junemann, Alessandro Ducati, Diego Garbossa
Neurophysiological monitoring is of undoubted value for the intraoperative safety of neurosurgical procedures. Widely developed and used for cranial surgery, it is equally as effective, though perhaps less commonly employed, for spinal pathology. The most frequently used techniques for intraoperative monitoring during spinal surgery include somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs) and electromyography, which can either be spontaneous free-running (sEMG) or triggered (tEMG). The knowledge of the benefits and limitations of each modality is essential in optimising the value of intraoperative monitoring during spinal procedures...
January 8, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29301602/progress-in-intraoperative-neurophysiological-monitoring-for-the-surgical-treatment-of-thoracic-spinal-stenosis
#8
Yong-Sheng Liu, Yu Zhao
Thoracic spinal stenosis (TSS) is a group of clinical syndromes caused by thoracic spinal cord compression, which always results in severe clinical complications. The incidence of TSS is relatively low compared with lumbar spinal stenosis, while the incidence of spinal cord injury during thoracic decompression is relatively high. The reported incidence of neurological deficits after thoracic decompression reached 13.9%. Intraoperative neurophysiological monitoring (IONM) can timely provide information regarding the function status of the spinal cord, and help surgeons with appropriate performance during operation...
December 30, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/29300714/electrophysiology-of-olfactory-and-optic-nerve-in-outpatient-and-intraoperative-settings
#9
Praveen Hariharan, Jeffery R Balzer, Katherine Anetakis, Donald J Crammond, Parthasarathy D Thirumala
Evoked potentials are time-locked electrophysiologic potentials recorded in response to standardized stimuli using scalp electrodes. These responses provide good temporal resolution and have been used in various clinical and intraoperative settings. Olfactory evoked potentials (OEPs) may be used as an adjunct tool in identifying patients of Parkinson disease and Alzheimer dementia. In clinical practice, visual evoked potentials (VEPs) are particularly useful in identifying subclinical cases of optic neuritis and in treatment surveillance...
January 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29289918/intraoperative-neurophysiological-monitoring-during-the-surgery-of-spinal-arteriovenous-malformation-sensitivity-specificity-and-warning-criteria
#10
Xiaoyu Li, Hong-Qi Zhang, Feng Ling, Chuan He, Peng Hu, Tao Hu, Jiaxing Yu
OBJECTIVE: The incidence of spinal arteriovenous malformation (SAVM) is low, but its treatment is challenging. Intraoperative neurophysiological monitoring (IONM) for intramedullary tumors has been a benchmark in neurosurgery. This study aimed to determine the sensitivity, specificity, and warning criteria of IONM for SAVM surgeries. MATERIALS AND METHODS: From November 2012 to January 2016, 55 patients underwent SAVM surgery with IONM at the Neurosurgery Department of Xuanwu Hospital of Capital Medical University, China...
February 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29241172/neurophysiological-monitoring-and-awake-craniotomy-for-resection-of-intracranial-gliomas
#11
Taiichi Saito, Manabu Tamura, Mikhail F Chernov, Soko Ikuta, Yoshihiro Muragaki, Takashi Maruyama
Aggressive resection of intracranial gliomas has a positive impact on patients' prognosis, but is associated with a risk of neurological complications. For preservation of brain functions and avoidance of major postoperative morbidity various methods of intraoperative neurophysiological monitoring have been introduced into clinical practice. At present, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), visual evoked potentials (VEP), brainstem auditory evoked potentials (BAEP), and electrocorticography (ECoG) are used routinely during neurosurgical procedures...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29236604/intraoperative-neuromonitoring-alarms-relationship-of-the-surgeon-s-decision-to-intervene-or-not-and-clinical-outcomes-in-a-subset-of-spinal-surgical-patients-with-a-new-postoperative-neurological-deficit
#12
Arvydas Tamkus, Kent S Rice, Howard L Kim
BACKGROUND: The goal of intraoperative neurophysiologic monitoring (IONM) is to minimize neurologic injury during surgery, yet patients still emerge with postoperative deficits. Few studies focus on outcomes relative to IONM alarms and interventions in this population. The authors sought to analyze the influence of IONM alarms with and without surgical intervention on patient outcome in spinal surgical patients who suffered immediate postoperative neurologic deficits. METHODS: Of 62,038 spinal surgeries with multimodality IONM, 90 patients with new or worsened postoperative neurologic deficits and whose outcomes were reported immediate to the surgery and at discharge were analyzed...
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/29236600/benefit-of-intraoperative-neurophysiological-monitoring-in-a-pediatric-patient-with-spinal-dysmorphism-split-cord-malformation-and-scoliosis
#13
Faisal R Jahangiri, Samir Al Sayegh, Moutasem Azzubi, Abdulrahman M Alrajhi, Monerah M Annaim, Shmoukh A Al Sharif, Tanweer Aziz, Sami Al Eissa
Intraoperative neurophysiological monitoring (IONM) consists of a group of neurodiagnostic techniques that assess the nervous system's functional integrity during surgical operations. A retrospective analysis of a pediatric female patient was conducted who underwent 12 operations for the correction of scoliosis, tethered cord, and split spinal cord wherein IONM played an important role. From age 3 to 6, she underwent six procedures including a release of the tethered cord, resection of the filum terminale, removal of a T11-T12 bony spur, release of L3 adhesions, repair of subcutaneous meningocele, and correction of scoliosis with a vertical expandable prosthetic titanium rod (VEPTR) technique without the use of IONM...
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/29186597/factors-for-a-good-surgical-outcome-in-posterior-decompression-and-dekyphotic-corrective-fusion-with-instrumentation-for-thoracic-ossification-of-the-posterior-longitudinal-ligament-prospective-single-center-study
#14
Shiro Imagama, Kei Ando, Kazuyoshi Kobayashi, Tetsuro Hida, Kenyu Ito, Mikito Tsushima, Yoshimoto Ishikawa, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Hiroaki Nakashima, Yoshihiro Nishida, Yukihiro Matsuyama, Naoki Ishiguro
BACKGROUND: Surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) is still challenging, and factors for good surgical outcomes are unknown. OBJECTIVE: To identify factors for good surgical outcomes with prospective and comparative study. METHODS: Seventy-one consecutive patients who underwent posterior decompression and instrumented fusion were divided into good or poor outcome groups based on ≥50% and <50% recovery rates for the Japanese Orthopaedic Association score...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29173429/intraoperative-neurophysiologic-monitoring-for-degenerative-cervical-myelopathy
#15
REVIEW
Masaaki Takeda, Satoshi Yamaguchi, Takafumi Mitsuhara, Masaru Abiko, Kaoru Kurisu
Multimodal intraoperative neurophysiologic monitoring is a reliable tool for detecting intraoperative spine injury and is recommended during surgery for degenerative cervical myopathy (DCM). Somatosensory evoked potential (SEP) can be used to monitor spine and peripheral nerve injury during positioning in surgery for DCM. Compensation technique for transcranial evoked muscle action potentials (tcMEPs) should be adopted in intraoperative monitoring during surgery for DCM. Free-running electromyography is a useful real-time monitoring add-on modality in addition to SEP and tcMEP...
January 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29147795/preoperative-pregabalin-has-no-effect-on-intraoperative-neurophysiological-monitoring-in-adolescents-undergoing-posterior-spinal-fusion-for-spinal-deformities-a-double-blind-randomized-placebo-controlled-clinical-trial
#16
Linda Helenius, Antti Puhakka, Tuula Manner, Olli Pajulo, Ilkka Helenius
PURPOSE: This study was designed to evaluate the effect of preoperative pregabalin on intraoperative neurophysiological monitoring in adolescents undergoing surgery for spinal deformities. METHODS: Thirty-one adolescents undergoing posterior spinal fusion were randomized to receive preoperatively either pregabalin 2 mg/kg twice daily or placebo. The ability to make reliable intraoperative neurophysiological measurements, transcranial motor (MEPs) and sensory evoked potentials (SSEP) was evaluated...
November 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29134342/an-introduction-and-overview-of-machine-learning-in-neurosurgical-care
#17
REVIEW
Joeky T Senders, Mark M Zaki, Aditya V Karhade, Bliss Chang, William B Gormley, Marike L Broekman, Timothy R Smith, Omar Arnaout
BACKGROUND: Machine learning (ML) is a branch of artificial intelligence that allows computers to learn from large complex datasets without being explicitly programmed. Although ML is already widely manifest in our daily lives in various forms, the considerable potential of ML has yet to find its way into mainstream medical research and day-to-day clinical care. The complex diagnostic and therapeutic modalities used in neurosurgery provide a vast amount of data that is ideally suited for ML models...
January 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29110082/continuous-monitoring-of-the-recurrent-laryngeal-nerve
#18
Aitor De la Quintana Basarrate, Arantza Iglesias Martínez, Iciar Salutregui, Leire Agirre Etxabe, Ainhoa Arana González, Izaskun Yurrebaso Santamaría
OBJECTIVE: The objective of this study was to assess the safety and utility of continuous intraoperative neuromonitoring for the prevention of recurrent laryngeal nerve injury during thyroidectomy. METHODS: A prospective cohort study was conducted in consecutive patients undergoing thyroidectomy. Variations in amplitude and distal latency of the electromyogram (EMG) were assessed. In the case of suspicious events, restorative manoeuvers were performed to attempt to recover the potentials...
November 6, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29101613/retained-medullary-cord-extending-to-a-sacral-subcutaneous-meningocele
#19
Nobuya Murakami, Takato Morioka, Takafumi Shimogawa, Kimiaki Hashiguchi, Nobutaka Mukae, Kazuyoshi Uchihashi, Satoshi O Suzuki, Koji Iihara
BACKGROUND: A retained medullary cord (RMC) is a rare closed spinal dysraphism with a robust elongated neural structure continuous from the conus and extending to the dural cul-de-sac. One case extending down to the base of a subcutaneous meningocele at the sacral level has been reported. CLINICAL PRESENTATION: We report on three cases of closed spinal dysraphism, in which a spinal cord-like tethering structure extended out from the dural cul-de-sac and terminated at a skin-covered meningocele sac in the sacrococcygeal region, which was well delineated in curvilinear coronal reconstructed images of 3D-heavily T2-weighted images (3D-hT2WI)...
November 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29076463/-application-of-intraoperative-electromagnetic-frameless-navigation-in-transcranial-and-endoscopic-neurosurgical-interventions
#20
V A Shurkhay, S A Goryaynov, M A Kutin, S A Eolchiyan, D N Capitanov, D V Fomichev, P L Kalinin, A N Shkarubo, D N Kopachev, A G Melikyan, M V Nersesyan, A M Shkatova, A N Konovalov, A A Potapov
The paper summarizes the experience in using a system of electromagnetic intraoperative frameless navigation in various neurosurgical pathologies of the brain. The electromagnetic navigation technique was used for 102 operations in 98 patients, including 36 transnasal endoscopic interventions. There were no intraoprtative and postoperative complications associated with the use of the system. In the process of using the system, factors influencing the accuracy of navigation and requiring additional control by the surgeon were identified...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
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