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Neurophysiology intraoperative monitoring

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https://www.readbyqxmd.com/read/29669030/the-efficacy-of-intraoperative-neurophysiological-monitoring-to-detect-postoperative-neurological-deficits-in-transforaminal-lumbar-interbody-fusion-surgery
#1
Joung Heon Kim, Svetlana Lenina, Grace Mosley, Joshua Meaike, Benjamin Tran, Jun S Kim, Samuel K Cho
BACKGROUND: Despite the extensive use of intraoperative neurophysiological monitoring (IONM) in spinal procedures, there is no standard guideline for what types of IONM tests should be monitored during lumbar procedures with instrumentation. Moreover, the efficacy of IONM during transforaminal lumbar interbody fusion (TLIF) surgery in detecting postoperative neurological deficits has not been well described. OBJECTIVE: To analyze waveform changes from individual IONM tests (somatosensory evoked potentials [SSEP], motor evoked potentials [MEP], and electromyography [EMG]) during TLIF and compare the sensitivity and specificity of these tests in order to determine the best combination to detect postoperative neurological deficits...
April 13, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29667095/can-postoperative-deltoid-weakness-after-cervical-laminoplasty-be-prevented-by-using-intraoperative-neurophysiological-monitoring
#2
Muneharu Ando, Tetsuya Tamaki, Takuji Matsumoto, Kazuhiro Maio, Masatoshi Teraguchi, Noboru Takiguchi, Hiroki Iwahashi, Makiko Onishi, Yukihiro Nakagawa, Hiroshi Iwasaki, Shunji Tsutsui, Masanari Takami, Hiroshi Yamada
Laminoplasty, frequently performed in patients with cervical myelopathy, is safe and provides relatively good results. However, motor palsy of the upper extremities, which occurs after decompression surgery for cervical myelopathy, often reduces muscle strength of the deltoid muscle, mainly in the C5 myotome. The aim of this study was to investigate prospectively whether postoperative deltoid weakness (DW) can be predicted by performing intraoperative neurophysiological monitoring (IONM) during cervical laminoplasty and to clarify whether it is possible to prevent palsy using IONM...
April 17, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29643629/intraoperative-neurophysiological-monitoring-team-s-communiqu%C3%A3-with-anesthesia-professionals
#3
Anurag Tewari, Lisa Francis, Ravi N Samy, Dean C Kurth, Joshua Castle, Tiffany Frye, Mohamed Mahmoud
Background and Aims: Intraoperative neurophysiological monitoring (IONM) is the standard of care during many spinal, vascular, and intracranial surgeries. High-quality perioperative care requires the communication and cooperation of several multidisciplinary teams. One of these multidisciplinary services is intraoperative neuromonitoring (IONM), while other teams represent anesthesia and surgery. Few studies have investigated the IONM team's objective communication with anesthesia providers...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29526251/robot-assisted-pudendal-neurolysis-in-the-treatment-of-pudendal-nerve-entrapment-syndrome
#4
P Moscatiello, D Carracedo Calvo, L Yupanqui Guerra, M E Rivera Martínez, A Mendiola de la Hoza, M Sánchez Encinas
INTRODUCTION: Pudendal nerve entrapment syndrome (PNE) is characterised by the presence of neuropathic pain in the pudendal nerve (PN) territory, associated or not with urinary, defecatory and sexual disorders. Surgical PN decompression is an effective and safe alternative for cases when conservative treatment fails. The aim of this study is to describe the first robot-assisted pudendal neurolysis procedure performed in our country. MATERIAL AND METHODS: We describe step by step the technique of robot-assisted laparoscopic neurolysis of the left PN performed with intraoperative neurophysiological monitoring on a 60-year-old patient diagnosed with left PNE...
March 8, 2018: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/29526069/clinical-and-radiological-outcomes-of-posterior-vertebral-column-resection-for-severe-spinal-deformities
#5
Byoung Hun Lee, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Yongjung J Kim, Hyun-Jib Kim
OBJECTIVE: The aim of this study was to investigate clinical and radiological outcomes of patients who underwent posterior vertebral column resection (PVCR) by a single neurosurgeon in a single institution. METHODS: Thirty-four consecutive patients with severe spinal deformities who underwent PVCR between 2010 and 2016 were enrolled. The radiographic measurements included a kyphotic angle of PVCR levels (VCR angle), sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis (LL), and spinopelvic parameters...
March 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29505853/use-of-motor-evoked-potentials-during-lateral-lumbar-interbody-fusion-reduces-postoperative-deficits
#6
Michael R Riley, Adam T Doan, Richard W Vogel, Alexander O Aguirre, Kayla S Pieri, Edward H Scheid
Background Context Intraoperative neurophysiological monitoring (IONM) has gained rather wide-spread acceptance as a method to mitigate risk to the lumbar plexus during Lateral Lumbar Interbody Fusion (LLIF) surgery. The most common approach to IONM involves using only electromyography (EMG) monitoring, and the rate of postoperative deficit remains unacceptably high. Other test modalities, such as transcranial electric motor-evoked potentials (tcMEPs) and somatosensory-evoked potentials (SSEPs), may be more suitable for monitoring neural integrity but they have not been widely adopted during LLIF...
March 2, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29501883/positive-pharmacologic-provocative-testing-with-methohexital-during-cerebral-arteriovenous-malformation-embolization
#7
Orhan Bican, Charles Cho, Leslie Lee, Viet Nguyen, Scheherazade Le, Jeremy Heit, Jaime Lopez
A middle-aged patient underwent staged endovascular embolization of a Spetzler-Martin grade V right parietal arteriovenous malformation(AVM).In the fifth endovascular embolization, after methohexital 10 mg injection into a right posterior choroidal artery feeding the AVM nidus, there was an immediate change in the electroencephalogram (EEG) with simultaneous loss of motor evoked potentials (MEPs) in the bilateral upper and lower extremities and a delayed change in somatosensory evoked potential responses (SSEPs)...
February 25, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29490011/awake-surgery-for-a-violin-player-monitoring-motor-and-music-performance-a-case-report
#8
Vitória Piai, Sandra H Vos, Reinhard Idelberger, Pauline Gans, Jonne Doorduin, Mark Ter Laan
Objective: We report the case of a professional violin player who underwent an awake craniotomy to resect a tumor in the left supplementary motor area, an area involved in motor planning. Method: A careful pre- and intraoperative monitoring plan for music performance and complex motor function was established that could be used in combination with cortical stimulation. Results: The patient suffered an epileptic seizure during cortical stimulation...
February 27, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/29462365/supratentorial-cavernous-malformations-involving-the-cortico-spinal-tract-and-sensory-motor-cortex-treatment-strategies-surgical-considerations-and-outcomes
#9
Miran Skrap, Maria Caterina Vescovi, Giada Pauletto, Marta Maieron, Tomasino Barbara, Daniele Bagatto, Francesco Tuniz
BACKGROUND: Cavernous malformations (CMs) are congenital malformations and may be located anywhere in the brain. We present a series of CMs located close to or inside of the motor-sensory cortex or corticospinal tract (CST) with clinical onset due to hemorrhage or mass effect. In such cases, surgery becomes an acceptable option. OBJECTIVE: To evaluate the role of diffusion tensor imaging (DTI), functional-magnetic-resonance imaging (fMRI), intraoperative neurophysiological monitoring, neuronavigation, and brain-mapping and the clinical results of surgical treatment of CMs in this critical location...
February 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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