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• W229828462 endingPage "2179" @default.
• W229828462 startingPage "2167" @default.
• W229828462 abstract "In Brief Study Design. Review of the literature with analysis of pooled data. Objective. To assess common intraoperative neuromonitoring (IOM) changes that occur during the course of spinal surgery, potential causes of change, and determine appropriate responses. Further, there will be discussion of appropriate application of IOM, and medical legal aspects. The structured literature review will answer the following questions: What are the various IOM methods currently available for spinal surgery? What are the sensitivities and specificities of each modality for neural element injury? How are the changes in each modality best interpreted? What is the appropriate response to indicated changes? Recommendations will be made as to the interpretation and appropriate response to IOM changes. Summary of Background Data. Total number of abstracts identified and reviewed was 187. Full review was performed on 18 articles. Methods. The MEDLINE database was queried using the search terms IOM, spinal surgery, SSEP, wake-up test, MEP, spontaneous and triggered electromyography alone and in various combinations. Abstracts were identified and reviewed. Individual case reports were excluded. Detailed information and data from appropriate articles were assessed and compiled. Results. Ability to achieve IOM baseline data varied from 70% to 98% for somatosensory-evoked potentials (SSEP) and 66% to 100% for motor-evoked potentials (MEP) in absence of neural axis abnormality. Multimodality intraoperative neuromonitoring (MIOM) provided false negatives in 0% to 0.79% of cases, whereas isolated SSEP monitoring alone provided false negative in 0.063% to 2.7% of cases. MIOM provided false positive warning in 0.6% to 1.38% of cases. Conclusion. As spine surgery, and patient comorbidity, becomes increasingly complex, IOM permits more aggressive deformity correction and tumor resection. Combination of SSEP and MEP monitoring provides assessment of entire spinal cord functionality in real time. Spontaneous and triggered electromyography add assessment of nerve roots. The wake-up test can continue to serve as a supplement when needed. MIOM may prove useful in preservation of neurologic function where an alteration of approach is possible. IOM is a valuable tool for optimization of outcome in complex spinal surgery. As spine surgery, and patient comorbidity, becomes increasingly complex, intraoperative neuromonitoring (IOM) permits optimization of outcome. Multimodality IOM provides assessment of entire spinal cord functionality in real time. Common IOM changes that occur during the course of spinal surgery, as well as potential causes of change and responses will be discussed." @default.
• W229828462 created "2016-06-24" @default.
• W229828462 creator A5005243568 @default.
• W229828462 creator A5043686090 @default.
• W229828462 date "2010-12-01" @default.
• W229828462 modified "2023-10-03" @default.
• W229828462 title "Intraoperative Electrophysiological Monitoring in Spine Surgery" @default.
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