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Intraoperative neurophysiological monitoring

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https://www.readbyqxmd.com/read/28436812/retrospective-waveform-analysis-of-transcranial-motor-evoked-potentials-mep-to-identify-early-predictors-of-impending-motor-deficits-in-spinal-surgeries
#1
Scheherazade Le, Viet Nguyen, Alexander C Ekwueme, S Charles Cho, Leslie Lee, Jaime López
PURPOSE: Although there are guidelines analyzing transcranial motor evoked potentials (MEP) waveform criteria, they vary widely and are not applied universally during intraoperative neurophysiologic monitoring (IONM). The objective is to generate hypotheses to identify early and reliable MEP waveform characteristics prior to complete loss of MEP to predict impending motor spinal cord injuries during spinal surgeries. The ultimate goal is to enhance real-time feedback to prevent injury or detect reversible spinal cord damage...
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/28409732/the-surgical-treatment-of-tumors-of-the-fourth-ventricle-a-single-institution-experience
#2
Sherise D Ferguson, Nicholas B Levine, Dima Suki, Andrew J Tsung, Fredrick F Lang, Raymond Sawaya, Jeffrey S Weinberg, Ian E McCutcheon
OBJECTIVE Fourth ventricle tumors are rare, and surgical series are typically small, comprising a single pathology, or focused exclusively on pediatric populations. This study investigated surgical outcome and complications following fourth ventricle tumor resection in a diverse patient population. This is the largest cohort of fourth ventricle tumors described in the literature to date. METHODS This is an 18-year (1993-2010) retrospective review of 55 cases involving patients undergoing surgery for tumors of the fourth ventricle...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28379572/risk-factors-for-ineffectiveness-of-posterior-decompression-and-dekyphotic-corrective-fusion-with-instrumentation-for-beak-type-thoracic-ossification-of-the-posterior-longitudinal-ligament-a-single-institute-study
#3
Shiro Imagama, Kei Ando, Zenya Ito, Kazuyoshi Kobayashi, Tetsuro Hida, Kenyu Ito, Mikito Tsushima, Yoshimoto Ishikawa, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Hiroaki Nakashima, Norimitsu Wakao, Yoshihiro Nishida, Yukihiro Matsuyama, Naoki Ishiguro
BACKGROUND: Thoracic ossification of the posterior longitudinal ligament (T-OPLL) is treated surgically with instrumented posterior decompression and fusion. However, the factors determining the outcome of this approach and the efficacy of additional resection of T-OPLL are unknown. OBJECTIVE: To identify these factors in a prospective study at a single institution. METHODS: The subjects were 70 consecutive patients with beak-type T-OPLL who underwent posterior decompression and dekyphotic fusion and had an average of 4...
March 30, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28377841/what-can-we-learn-from-two-consecutive-cases-droperidol-may-abolish-tcmeps
#4
Ángel Saponaro González, Pedro Javier Pérez Lorensu, Santiago Chaves Gómez, Josué Francisco Nodarse Medina, Jose Ángel Torres Dios
Droperidol is a D2 receptor antagonist currently used in Europe for preventing postoperative nausea and vomiting. It was used to perform neurolept anaesthesia in combination with fentanyl until a Food and Drug Administration (FDA) 'black box' warning restricted its use due to cardiovascular side effects in 2001. There is no literature regarding the effects of droperidol on transcranial motor evoked potentials (TcMEPs) elicited by electrical stimulation. Our aim was to report two cases of spine surgery in which TcMEPs were lost due to droperidol administration...
February 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28362960/ipsilateral-motor-innervation-discovered-incidentally-on-intraoperative-monitoring-a-case-report
#5
Jerry Ku, Daniel Mendelsohn, Jason Chew, Jason Shewchuk, Charles Dong, Ryojo Akagami
BACKGROUND AND IMPORTANCE: Lesions in the corticospinal tract above the decussation at the medullary pyramids almost universally produce contralateral deficits. Rare cases of supratentorial lesions causing ipsilateral motor deficits have been reported previously, but only ever found secondary to stroke or congenital pyramidal tract malformations. CLINICAL PRESENTATION: Herein, we report a case of ipsilateral corticospinal tract innervation discovered incidentally with intraoperative monitoring during a microsurgical resection of a vestibular schwannoma...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327942/evaluation-of-the-high-frequency-monopolar-stimulation-technique-for-mapping-and-monitoring-the-corticospinal-tract-in-patients-with-supratentorial-gliomas-a-proposal-for-intraoperative-management-based-on-neurophysiological-data-analysis-in-a-series-of-ninety
#6
Gerard Plans, Isabel Fernández-Conejero, Xavier Rifà-Ros, Alejandro Fernández-Coello, Aleix Rosselló, Andreu Gabarrós
BACKGROUND: Intraoperative identification and preservation of the corticospinal tract is often necessary for glioma resection. OBJECTIVE: To make a proposal for intraoperative management with the high-frequency monopolar stimulation technique for monitoring the corticospinal tract. METHODS: Ninety-two patients operated on with the assistance of the high-frequency monopolar stimulation. Clinical and neurophysiological data have been related with the motor status at 3 months to establish prognostic factors of motor deterioration...
January 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28324227/intraoperative-neurophysiologic-monitoring-in-spinal-intradural-extramedullary-tumors-only-a-prognostic-tool
#7
REVIEW
D Nasi, R Ghadirpour, F Servadei
No abstract text is available yet for this article.
March 21, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28291212/-surgical-treatment-of-eloquent-brain-area-tumors-using-neurophysiological-mapping-of-the-speech-and-motor-areas-and-conduction-tracts
#8
A A Zuev, E N Korotchenko, D S Ivanova, N V Pedyash, B A Teplykh
AIM: To evaluate the efficacy of intraoperative neurophysiological mapping in removing eloquent brain area tumors (EBATs). MATERIAL AND METHODS: Sixty five EBAT patients underwent surgical treatment using intraoperative neurophysiological mapping at the Pirogov National Medical and Surgical Center in the period from 2014 to 2015. On primary neurological examination, 46 (71%) patients were detected with motor deficits of varying severity. Speech disorders were diagnosed in 17 (26%) patients...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28259263/prognosis-of-significant-intraoperative-neurophysiologic-monitoring-events-in-severe-spinal-deformity-surgery
#9
Benjamin T Bjerke, Daniel M Zuchelli, Venu M Nemani, Ronald G Emerson, Han Jo Kim, Oheneba Boachie-Adjei
BACKGROUND: Intraoperative neurophysiologic monitoring has become a standard tool for mitigating neurologic injury during spinal deformity surgery. Significant monitoring changes during deformity correction are relatively uncommon. This study characterizes precipitating factors for neurologic injury and relates significant events and postoperative neurologic prognosis. METHODS: All spinal deformity surgeries at a West African hospital over a 12-month period were reviewed...
March 2017: Spine Deformity
https://www.readbyqxmd.com/read/28185615/clinical-study-of-neuroregen-scaffold-combined-with-human-mesenchymal-stem-cells-for-the-repair-of-chronic-complete-spinal-cord-injury
#10
Yannan Zhao, Fengwu Tang, Guang Han, Nuo Wang, Na Yin, Bing Chen, Xianfeng Jiang, Chen Yun, Wanjun Han, Changyu Zhao, Shixiang Cheng, Zhifeng Xiao, Sai Zhang, Jianwu Dai
Regeneration of damaged neurons and recovery of sensation and motor function after complete spinal cord injury (SCI) are challenging. We previously developed a collagen scaffold, NeuroRegen scaffold, to promote axonal growth along collagen fibers and inhibit glial scar formation after SCI. When functionalized with multiple biomolecules, this scaffold promoted neurological regeneration and functional recovery in animals with SCI. In this study, eight patients with chronic complete SCI were enrolled to examine the safety and efficacy of implanting NeuroRegen scaffold with human umbilical cord mesenchymal stem cells (MSCs)...
February 9, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28175547/319%C3%A2-predictive-value-of-intraoperative-neurophysiological-monitoring-during-spine-surgery-a-prospective-analysis-of-4489-consecutive-patients
#11
Matthew Pease, Gurpreet Surinder Gandhoke, Jaspreet Kaur, Parthasarthy Thirumala, Jeffrey Balzer, Donald Crammond, David O Okonkwo, Adam S Kanter
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28138779/outcome-of-l5-radiculopathy-after-reduction-and-instrumented-transforaminal-lumbar-interbody-fusion-of-high-grade-l5-s1-isthmic-spondylolisthesis-and-the-role-of-intraoperative-neurophysiological-monitoring
#12
Ralph T Schär, Martin Sutter, Anne F Mannion, Andreas Eggspühler, Dezsö Jeszenszky, Tamas F Fekete, Frank Kleinstück, Daniel Haschtmann
PURPOSE: To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5-S1 isthmic spondylolisthesis and the role of intraoperative neurophysiological monitoring (IONM). METHODS: Consecutive patients treated for high-grade spondylolisthesis with IONM from 2005 to 2013 were screened for eligibility. Prospectively collected clinical and surgical data as well as radiographic outcomes were analyzed retrospectively...
January 31, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28130655/spinal-intradural-extramedullary-tumors-the-value-of-intraoperative-neurophysiologic-monitoring-on-surgical-outcome
#13
Ran Harel, David Schleifer, Shmuel Appel, Moshe Attia, Zvi R Cohen, Nachshon Knoller
Nerve sheath tumors and meningiomas account for most intradural extramedullary (IDEM) tumors. These tumors are benign and amenable to complete surgical resection. In recent years, these surgeries are performed with intraoperative neurophysiologic monitoring (IONM) in order to minimize neurological injury, but the evidence for the statistical efficacy of this utility is lacking. This paper evaluates IONM benefits in IDEM tumor resection. Data of patients treated surgically for spinal intradural tumors from 1998 to 2003 was previously collected and analyzed...
January 27, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28120082/intraoperative-neurophysiological-monitoring-in-spine-surgery-a-significant-tool-for-neuronal-protection-and-functional-restoration
#14
Antonino Scibilia, Giovanni Raffa, Vincenzo Rizzo, Angelo Quartarone, Massimiliano Visocchi, Antonino Germanò, Francesco Tomasello
Although there is recent evidence for the role of intraoperative neurophysiological monitoring (IONM) in spine surgery, there are no uniform opinions on the optimal combination of the different tools. At our institution, multimodal IONM (mIONM) approach in spine surgery involves the evaluation of somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) with electrical transcranial stimulation, including the use of a multipulse technique with multiple myomeric registration of responses from limbs, and a single-pulse technique with D-wave registration through epi- and intradural recording, and free running and evoked electromyography (frEMG and eEMG) with bilateral recording from segmental target muscles...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28120080/functional-magnetic-resonance-imaging-fmri-pre-intraoperative-tractography-in-neurosurgery-the-experience-of-sant-andrea-rome-university-hospital
#15
Giancarlo D'Andrea, Giuseppe Trillo', Veronica Picotti, Antonino Raco
BACKGROUND: The goal of neurosurgery for cerebral intraparenchymal neoplasms of the eloquent areas is maximal resection with the preservation of normal functions, and minimizing operative risk and postoperative morbidity. Currently, modern technological advances in neuroradiological tools, neuronavigation, and intraoperative magnetic resonance imaging (MRI) have produced great improvements in postoperative morbidity after the surgery of cerebral eloquent areas. The integration of preoperative functional MRI (fMRI), intraoperative MRI (volumetric and diffusion tensor imaging [DTI]), and neuronavigation, defined as "functional neuronavigation" has improved the intraoperative detection of the eloquent areas...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28089323/neurophysiological-monitoring-of-lumbar-spinal-nerve-roots-a-case-report-of-postoperative-deficit-and-literature-review
#16
Yuguang Chen, Baoqing P Wang, Junlin Yang, Yaolong Deng
INTRODUCTION: Intraoperative neurophysiological monitoring (IONM) has proven to help reduce the probability of postoperative neurological deficit for spinal deformity correctional surgeries. However, in rare cases new deficits may still happen. We report a surgical case in which the patient had postoperative paralysis. We would like to call for more case reports with postoperative neurological deficits as they present difficult clinical cases. PRESENTATION OF CASE: A 61-year-old male patient with severe thoracolumbar kyphoscoliosis underwent posterior spinal correction and fusion with segmental T10-L5 pedicle screws and rods instrumentation with IONM...
November 19, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28045855/the-interpretation-of-muscle-motor-evoked-potentials-for-spinal-cord-monitoring
#17
REVIEW
Karl F Kothbauer
OBJECTIVE: To provide a summary of the intraoperative monitoring of muscle motor evoked potentials (MEPs) based on the presence-absence concept during neurosurgical operations along the spinal cord. METHOD: Expert review. DISCUSSION: The measurable parameters of MEPs, such as signal amplitudes and thresholds vary considerably both during a single surgery in a single individual patient as well as between individuals and operations. The presence or absence of responses irrespective of stimulus intensity and response amplitude is much more clearly defined...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28019107/gross-total-resection-rates-of-grade-ii-iii-intramedullary-ependymomas-using-the-surgical-strategy-of-en-bloc-resection-without-intra-operative-neurophysiological-monitoring
#18
Kieron J Sweeney, Matt Reynolds, Michael Farrell, Ciaran Bolger
INTRODUCTION: Grade II and III intramedullary ependymomas [IME] are circumscribed with a plane of cleavage that should facilitate high gross total resection rates (GTR). Gross total resection of grade II/III IME is superior to subtotal resection (STR) and radiotherapy (RTx) for progression-free and overall survival. We sought to compare our GTR with other series that have utilised standard intraoperative monitoring techniques and we explored factors that may influence rates of resection...
December 25, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28017534/direct-motor-evoked-potentials-and-cortical-mapping-using-the-nim%C3%A2-nerve-monitoring-system-a-technical-note
#19
Suparna Bharadwaj, Faizal Haji, Matthew Hebb, Jason Chui
Motor evoked potentials (MEPs) are commonly used to prevent neurological injury when operating in close proximity to the motor cortex or corticospinal pathway. We report a novel application of the NIM® nerve monitoring system (Medtronic@ NIM response 3.0) for intraoperative direct cortical (dc)-MEPs monitoring. A 69-year-old female patient presented with a 4month history of progressive left hemiparesis resulting from a large right sided posterior frontal meningioma that abutted and compressed the motor cortex...
April 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28010998/comparison-of-multimodal-intraoperative-neurophysiological-monitoring-efficacy-in-early-childhood-and-school-aged-children-undergoing-spinal-surgery
#20
COMPARATIVE STUDY
Alpaslan Şenköylü, Murat Zinnuroğlu, Alp Börçek, Erdem Aktaş, İrfan Güngör, Mehmet Beyazova
OBJECTIVE: The aim of this study was to compare the performance of multimodal intraoperative neurophysiological monitoring (MIONM) in children below and over 6 years of age. METHODS: 43 children, diagnosed with spinal pathologies were divided into two cohorts according to their age and enrolled in the study. Those under the age of 6 consisted group A, whereas those between the age of 6 and 11 consisted group B. All patients underwent spinal surgical procedures according to their diagnosis...
January 2017: Acta Orthopaedica et Traumatologica Turcica
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