Abstract
Intraoperative neuromonitoring is an essential modality for ensuring safety of neurosurgical procedures of the spinal cord. Many techniques have come into regular clinical use within the last decade, and their utility recognized as guideline recommendations. This chapter will provide a broad overview of the common electrophysiological monitoring methods of the spinal cord including somatosensory evoked potentials, motor evoked potentials, spontaneous electromyography, and pedicle screw monitoring.
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References
Møller AR. Introduction. In: Intraoperative neurophysiological monitoring. 2nd ed. New York: Springer; 2011. p. 1–6.
Møller AR. Monitoring somatosensory evoked potentials. In: Intraoperative neurophysiological monitoring. New York: Springer; 2011. p. 93–122.
Møller AR. Anatomy and physiology of sensory systems. In: Intraoperative neurophysiological monitoring. New York: Springer; 2011. p. 57–92.
Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE. Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol. 1995;96:6–11.
Hilibrand AS, Schwartz DM, Sethuraman V, Vaccaro AR, Albert TJ. Comparison of transcranial electric motor and somatosensory evoked potential monitoring during cervical spine surgery. J Bone Joint Surg Am. 2004;86–A:1248–53.
Hadley MN, Shank CD, Rozzelle CJ, Walters BC. Guidelines for the use of electrophysiological monitoring for surgery of the human spinal column and spinal cord. Neurosurgery. 2017;81:713–32.
Mehta AI, Mohrhaus CA, Husain AM, Karikari IO, Hughes B, Hodges T, Gottfried O, Bagley CA. Dorsal column mapping for intramedullary spinal cord tumor resection decreases dorsal column dysfunction. J Spinal Disord Tech. 2012;25:205–9.
Taniguchi M, Cedzich C, Schramm J. Modification of cortical stimulation for motor evoked potentials under general anesthesia: technical description. Neurosurgery. 1993;32:219–26.
Møller AR. Anatomy and physiology of motor systems. In: Intraoperative neurophysiological monitoring. New York: Springer; 2011. p. 169–205.
Shigematsu H, Kawaguchi M, Hayashi H, et al. Higher success rate with transcranial electrical stimulation of motor-evoked potentials using constant-voltage stimulation compared with constant-current stimulation in patients undergoing spinal surgery. Spine J. 2017;17:1472–9.
Møller AR. Practical aspects of monitoring spinal motor systems. In: Intraoperative neurophysiological monitoring. 2nd ed. New York: Springer; 2011. p. 207–34.
Legatt AD, Emerson RG, Epstein CM, MacDonald DB, Deletis V, Bravo RJ, López JR. ACNS Guideline. J Clin Neurophysiol. 2016;33:42–50.
Lee JJ, Il KY, Hong JT, Sung JH, Lee SW, Yang SH. Intraoperative monitoring of motor-evoked potentials for supratentorial tumor surgery. J Korean Neurosurg Soc. 2014;56:98–102.
Chen R, Cros D, Curra A, et al. The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol. 2008;119:504–32.
Péréon Y, Tich SNT, Delécrin J, Dang CP, Bodin J, Drouet JC, Passuti N. Combined spinal cord monitoring using neurogenic mixed evoked potentials and collision techniques. Spine (Phila Pa 1976). 2002;27(14):1571–6.
Sloan TB, Erian R. Effect of vecuronium-induced neuromuscular blockade on cortical motor evoked potentials. Anesthesiology. 1993;78:966–73.
Kim S-H, Jin S-J, Karm M-H, Moon Y-J, Jeong H-W, Kim J-W, Ha S-I, Kim J-U. Comparison of false-negative/positive results of intraoperative evoked potential monitoring between no and partial neuromuscular blockade in patients receiving propofol/remifentanil-based anesthesia during cerebral aneurysm clipping surgery. Medicine (Baltimore). 2016;95:e4725.
Journée HL, Berends HI, Kruyt MC. The percentage of amplitude decrease warning criteria for Transcranial MEP monitoring. J Clin Neurophysiol. 2017;34:22–31.
MacDonald DB. Overview on criteria for MEP monitoring. J Clin Neurophysiol. 2017;34:4–11.
Park J-H, Hyun S-J. Intraoperative neurophysiological monitoring in spinal surgery. World J Clin Cases. 2015;3:765–73.
Lall RR, Lall RR, Hauptman JS, Munoz C, Cybulski GR, Koski T, Ganju A, Fessler RG, Smith ZA. Intraoperative neurophysiological monitoring in spine surgery: indications, efficacy, and role of the preoperative checklist. Neurosurg Focus. 2012;33:E10.
Calancie B, Lebwohl N, Madsen P, Klose KJ. Intraoperative evoked EMG monitoring in an animal model. A new technique for evaluating pedicle screw placement. Spine (Phila Pa 1976). 1992;17:1229–35.
Raynor BL, Lenke LG, Bridwell KH, Taylor BA, Padberg AM. Correlation between low triggered electromyographic thresholds and lumbar pedicle screw malposition. Spine (Phila Pa 1976). 2007;32:2673–8.
Bosnjak R, Dolenc VV. Electrical thresholds for biomechanical response in the ankle to direct stimulation of spinal roots L4, L5, and S1. Implications for intraoperative pedicle screw testing. Spine (Phila Pa 1976). 2000;25:703–8.
Parker SL, Amin AG, Farber SH, McGirt MJ, Sciubba DM, Wolinsky J-P, Bydon A, Gokaslan ZL, Witham TF. Ability of electromyographic monitoring to determine the presence of malpositioned pedicle screws in the lumbosacral spine: analysis of 2450 consecutively placed screws. J Neurosurg Spine. 2011;15:130–5.
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Chakrabarti, D., Srinivas, D. (2019). Intraoperative Neuromonitoring for the Spine. In: Prabhakar, H., Ali, Z. (eds) Textbook of Neuroanesthesia and Neurocritical Care. Springer, Singapore. https://doi.org/10.1007/978-981-13-3387-3_5
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DOI: https://doi.org/10.1007/978-981-13-3387-3_5
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