2,445 results match your criteria Intraoperative Neurophysiological Monitoring

Intra-Operative Neurophysiological Monitoring in Patients with Intraspinal Abnormalities Undergoing Posterior Spinal Fusion.

Orthop Surg 2022 Jun 16. Epub 2022 Jun 16.

Division of Spine Surgery, Department of Orthopaedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.

Objective: To analyze the intraoperative neurophysiological monitoring (IONM) data of patients with intraspinal abnormalities undergoing posterior spinal fusion and to determine how intraspinal abnormalities influence IONM results.

Methods: Patients with severe kyphoscoliosis and intraspinal abnormalities who underwent posterior spinal correction and fusion between September 2015 and January 2019 were retrospectively reviewed. Candidate intraspinal abnormalities included Chiari malformation, syringomyelia, split cord malformation, and tethered cord syndrome. Read More

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Deliberate Parent Artery Sacrifice Guided by Intraoperative Neurophysiological Monitoring During Complex Surgical Clipping of a Ruptured Anterior Communicating Artery Aneurysm.

Neurodiagn J 2022 Jun;62(2):108-119

Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra, New York, New York.

Aneurysms arising from the anterior communicating artery (ACOA) are the most common intracranial aneurysms encountered. Most aneurysms can be treated with surgical clipping or endovascular coiling; however, there are times when parent vessel sacrifice (PVS) is necessary such as aneurysms with fragile necks or large/giant aneurysms. Application of intraoperative neurophysiological monitoring (IONM) can assist in guiding permissive temporary vessel occlusion during complex aneurysm clippings. Read More

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Subdural Direct Wave Intraoperative Neurophysiological Monitoring in Intramedullary Spinal Cord Tumor Resection: Case Report.

Neurodiagn J 2022 Jun;62(2):87-98

Department of Neurosurgery, Lenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra, New York, New York.

Direct wave (D-wave) intraoperative neurophysiological monitoring (IONM) is used during intramedullary spinal cord tumor (IMSCT) resection to assess corticospinal tract (CST) integrity. There are several obstacles to obtaining consistent and reliable D-wave monitoring and modifications to standard IONM procedures may improve surgical resection. We present the case of a subependymoma IMSCT resection at the T2-T6 spinal levels where subdural D-wave monitoring was implemented. Read More

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Motor Mapping of the Brain: Taniguchi Versus Penfield Method.

Cureus 2022 May 11;14(5):e24901. Epub 2022 May 11.

Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, USA.

Intraoperative neurophysiological monitoring (IONM) techniques continue to prove useful as an adjunct in select surgeries for reducing the incidence of various postoperative deficits in motor function through the monitoring of motor evoked potentials (MEPs). The Penfield and Taniguchi methods of direct electrical cortical stimulation (DECS) stand in contrast to each other. Penfield's method uses lower-frequency stimulation over a longer duration, while Taniguchi's method uses a relatively higher frequency over a short duration. Read More

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[Efficacy of microscopic surgery for cervical peripheral nerve tumors].

Zhonghua Yi Xue Za Zhi 2022 May;102(20):1530-1532

Department of Neurosurgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

The clinical treatment and follow-up results of 51 patients with cervical peripheral nerve tumors treated by microsurgery in the Department of Neurosurgery of Beijing Friendship Hospital Affiliated to Capital Medical University from January 2016 to October 2021 were retrospectively analyzed. Total tumor resection was performed in 49 patients (96.1%), and 42 patients (82. Read More

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Benign Peripheral Non-cranial Nerve Sheath Tumors of the Neck.

Adv Ther 2022 Jun 11. Epub 2022 Jun 11.

Coordinator of the International Head and Neck Scientific Group, Padua, Italy.

Benign peripheral non-cranial nerve sheath tumors are rare lesions, including both schwannomas and neurofibromas. These tumors arise from Schwann cells, and may originate from any peripheral, cranial, or autonomic nerve. Most of them are localized and sporadic but multifocal systemic forms can occur. Read More

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Facial Nerve Function After Microsurgical Resection in Vestibular Schwannoma Under Neurophysiological Monitoring.

Front Neurol 2022 24;13:850326. Epub 2022 May 24.

Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany.

Background: The use of intraoperative neurophysiological monitoring, including direct nerve stimulation (especially the facial nerve), acoustic evoked potentials (AEP) and somatosensory evoked potentials (SSEP), is a helpful tool in the microsurgery of vestibular schwannoma to prevent nerve injury. Patient characteristics and intraoperative and postoperative variables might also influence the postoperative facial nerve function. The study was performed to investigate these variables and the intraoperative neurophysiological monitoring values. Read More

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Application of Controlled Hypotension During Surgery for Spinal Metastasis.

Technol Cancer Res Treat 2022 Jan-Dec;21:15330338221105718

74768Tianjin Hospital, Tianjin, China.

With advances in tumor treatment, metastasis to bone is increasing, and surgery has become the only choice for most terminal patients. However, spinal surgery has a high risk and is prone to heavy bleeding. Controlled hypotension during surgery has outstanding advantages in reducing intraoperative bleeding and ensuring a clear field of vision, thus avoiding damage to important nerves and vessels. Read More

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Factors Related to Hemifacial Spasm Recurrence in Patients Undergoing Microvascular Decompression-A Systematic Review and Meta-Analysis.

Brain Sci 2022 Apr 29;12(5). Epub 2022 Apr 29.

Department of Neuroscience, Neurosurgery Section, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

There is a lack of knowledge about the factors associated with the recurrence of hemifacial spam (HFS) following an initially successful microvascular decompression (MVD) surgery. The aim of the present study was to systematically review the pertinent literature and carry out a meta-analysis of factors linked to HFS recurrence in patients undergoing initially successful MVD treatment. An online literature search was launched on the PubMed/Medline and Scopus databases. Read More

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Localization of macroscopically undetectable intramedullary hematoma by intraoperative epidural motor evoked potential.

Clin Neurophysiol Pract 2022 22;7:129-134. Epub 2022 Apr 22.

Department of Neurosurgery, University of Szeged, Hungary.

Introduction: Intramedullary hematoma is an uncommon, serious neurological disease, representing a diagnostic challenge. The preferred treatment is surgical. In most of the cases the lesion can be identified macroscopically. Read More

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Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences.

J Clin Med 2022 May 5;11(9). Epub 2022 May 5.

Department of Surgical Sciences, Division of Orthopaedics, Uppsala University, 75185 Uppsala, Sweden.

The aim was to investigate the role of preoperative magnetic resonance imaging (MRI) and intraoperative monitoring (IOM) in the prevention of correction-related complications in idiopathic scoliosis (IS). We conducted a retrospective case study of 129 patients with juvenile and adolescent IS. The operations took place between 2005 and 2018 in Uppsala University Hospital. Read More

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Cardiovascular-related mortality after intraoperative neurophysiologic monitoring changes during carotid endarterectomy.

Clin Neurophysiol 2022 Jul 22;139:43-48. Epub 2022 Apr 22.

Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address:

Objective: We examined significant intraoperative neurophysiologic monitoring (IONM) changes and perioperative stroke as independent risk factors of long-term cardiovascular-related mortality in patients who have undergone carotid endarterectomy (CEA).

Methods: Records of patients who underwent CEA with IONM at the University of Pittsburgh Medical Center between January 1, 2009 and December 31, 2019 were analyzed retrospectively. Cardiovascular-related mortality was compared between the significant IONM change group and no IONM change group and between the perioperative stroke group and no perioperative stroke group. Read More

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The application of intraoperative neurophysiological monitoring in selective dorsal neurotomy for primary premature ejaculation: a prospective single-center study.

Asian J Androl 2022 Apr 22. Epub 2022 Apr 22.

Department of Andrology, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing 210008, China.

Selective dorsal neurotomy (SDN) is a surgical treatment for primary premature ejaculation (PE), but there is still no standard surgical procedure for selecting the branches of the dorsal penile nerves to be removed. We performed this study to explore the value of intraoperative neurophysiological monitoring (IONM) of the penile sensory-evoked potential (PSEP) for standard surgical procedures in SDN. One hundred and twenty primary PE patients undergoing SDN were selected as the PE group and 120 non-PE patients were selected as the normal group. Read More

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Effect of GOAL-Directed ANalgesia using ANI (Analgesia/Nociception Index) during general anesthesia on immediate postoperative pain and intraoperative hemodynamics in adult patients (GOALDAN study): a study protocol for randomized, controlled, multicenter trial.

Trials 2022 Apr 25;23(1):353. Epub 2022 Apr 25.

APCSe VetAgro Sup UPSP 2016.A101, Claude Bernard Lyon 1 University, Université de Lyon, Marcy-l'Étoile, France.

Background: Severe postoperative pain remains a major problem that is seen in 20 to 40% of patients. The Analgesia/Nociception Index (ANI) is a 0-100 index reflecting the relative parasympathetic activity allowing for intraoperative analgesia monitoring. We have previously shown that an ANI value < 50 immediately before extubation may predict the occurrence of immediate postoperative pain with good performance. Read More

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Intraoperative Monitoring for Spinal Surgery.

Neurol Clin 2022 05 31;40(2):269-281. Epub 2022 Mar 31.

Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, M779, San Francisco, CA 94143, USA.

The use of intraoperative neuromonitoring (IONM) can improve surgical outcomes. Although inclusion of IONM is considered standard practice in more complicated spine surgeries, there are no national-level guidelines for the usage of IONM in spine surgery. Technical advancement in IONM has increased both its sensitivity and specificity, and with a recently developed algorithmic checklist it can be more easily adopted by the surgical team in their practice. Read More

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Fast or Slow? A Comparison Between Two Transcranial Electrical Stimulation Techniques for Eliciting Motor-Evoked Potentials During Supratentorial Surgery.

J Clin Neurophysiol 2021 Oct 12. Epub 2021 Oct 12.

Neurology and Clinical Neurophysiology Unit, "S. Maria della Misericordia" University-Hospital, Udine, Italy.

Purpose: During intraoperative neurophysiological monitoring of motor pathways, two types of transcranial electrical stimulation are available, i.e., constant-current and constant-voltage stimulation. Read More

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October 2021

Estimating Intraoperative Neurophysiological Monitoring Rates for Anterior Cervical Discectomy and Fusion: Are Diagnostic or Procedural Codes Accurate?

Int J Spine Surg 2022 Apr;16(2):208-214

Department of Neurology, Mayo Clinic, Rochester, MN, USA

Background: The utility of intraoperative neurophysiological monitoring (IONM) is well established for some spine surgeries (eg, intramedullary tumor resection, scoliosis deformity correction), but its benefit for most degenerative spine surgery, including anterior cervical discectomy and fusion (ACDF), remains debated. National datasets provide "big data" approaches to study the impact of IONM on spine surgery outcomes; however, if administrative coding in these datasets misrepresents actual IONM usage, conclusions will be unreliable. The objective of this study was to compare estimated rates (administrative coding) to actual rates (chart review) of IONM for ACDF at our institution and extrapolate findings to estimated rates from 2 national datasets. Read More

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Relevance of intraoperative motor evoked potentials and D-wave monitoring for the resection of intramedullary spinal cord tumors in children.

Neurosurg Rev 2022 Apr 13. Epub 2022 Apr 13.

Department of Pediatric Neurosurgery, Medical University of Silesia, Katowice, Poland.

The purpose of this study was to evaluate the reliability of motor evoked potentials (MEP), somatosensory evoked potentials (SSEP), and D-wave monitoring as predictors of postoperative neurological deficits in pediatric patients undergoing resection of intramedullary spinal cord tumors (IMSCTs). Additionally, we aimed to determine whether alerts in the intraoperative neurophysiological monitoring (IONM) influenced the extent of resection (EOR). A retrospective analysis of the pediatric patients who underwent resection of IMSCT between March 2010 and April 2021 with an IONM guidance was performed. Read More

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Resection of Giant Remote Recurrence of Ependymoma After 41 Years.

World Neurosurg 2022 Jul 9;163:38. Epub 2022 Apr 9.

Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida, USA.

Ependymomas are rare primary tumors of the brain and spinal cord that arises from the ependymal cell layer. Cranial ependymomas commonly occur in the posterior fossa; however, approximately 30% of all tumors can be found in the supratentorial region. Supratentorial ependymomas have a shorter progression-free and overall survival than their infratentorial counterparts. Read More

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Transcranial electrical stimulation elicits short and long latency responses in the tongue muscles.

Clin Neurophysiol 2022 06 28;138:148-152. Epub 2022 Mar 28.

Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Klinisches Neurowissenschaften Zentrum, Universität Zürich, Switzerland.

Objective: Intraoperative transcranial electrical stimulation evokes a motor response at short latency (SLR) of a few milliseconds in cranial nerves innervated muscles. In addition, a long latency response (LLR) is known for the laryngeal nerve. We present here the LLR in the tongue muscles. Read More

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Predictors of functional outcome after spinal cord surgery: Relevance of intraoperative neurophysiological monitoring combined with preoperative neurophysiological and MRI assessments.

Neurophysiol Clin 2022 Jun 5;52(3):242-251. Epub 2022 Apr 5.

Hospices Civils de Lyon, Hôpital neurologique Pierre Wertheimer, Service de Neurologie Fonctionnelle et Epileptologie, Lyon, France; Université Lyon I, Université Claude Bernard, Lyon, France; Centre de Recherche de Neurosciences de Lyon, INSERM UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, F-69000 Lyon, France.

Objectives: To assess the accuracy of intraoperative neurophysiological monitoring (IONM) in predicting immediate and 3-month postoperative neurological new deficit (or deterioration) in patients benefiting from spinal cord (SC) surgery; and to identify factors associated with a higher risk of postoperative clinical worsening.

Methods: Consecutive patients who underwent SC surgery with IONM were included. Pre and postoperative clinical (modified McCormick scale), radiological (lesion-occupying area ratio), and electrophysiological features were collected. Read More

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Surgical management of giant calcified thoracic disc herniation and the role of neuromonitoring. The outcome of large mono centric series.

J Clin Neurosci 2022 Jun 4;100:37-45. Epub 2022 Apr 4.

A.U.O. "Policlinico Umberto I" - Neurosurgery Division - Sapienza University - Rome - Human Neurosciences Department - Via del Policlinico, 155 - 00161 Roma, Italy.

Purpose: Giant thoracic disc herniations (GTDH) are considered a subgroup of TDHs with worse functional outcomes, a high calcification rate, and a considerable risk of complications. We aimed to determine whether there is a relationship between the extent of calcification of GTDH and outcomes concerning the risk of complications, the surgical technique, and changes in neuromonitoring signals.

Methods: We present a retrospective analysis of 76 patients undergoing surgery for calcific GTDH. Read More

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Thalamic Tumors in a Pediatric Population: Surgical Outcomes and Utilization of High-Definition Fiber Tractography and the Fiber Tracking Technique.

Cureus 2022 Mar 29;14(3):e23611. Epub 2022 Mar 29.

Pediatric Neurosurgery, King Fahad Medical City/National Neuroscience Institute, Riyadh, SAU.

Objective: This study aimed to assess the operability of thalamic tumors since they are generally considered to be inoperable and to have poor outcomes. Advancements in neuroimaging, neuronavigational technology, and intraoperative neurophysiological monitoring allow accurate planning and safe resection.

Methods: Clinical data and reports of 10 pediatric patients with thalamic tumors were retrieved retrospectively. Read More

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Unexpected median SEPs fluctuations during brain cavernous malformation resection with no post-operative deficit.

J Clin Monit Comput 2022 Mar 31. Epub 2022 Mar 31.

Department of Intraoperative Neurophysiology, Mount Sinai West Hospital, 1000, 10th Avenue, Suite 2B30, New York, NY, 10019, USA.

Median nerve somatosensory evoked potentials (SEPs) may present changes during cavernous malformation (CM) resection unrelated to new post-operative sensory deficits. We performed intraoperative neurophysiological monitoring of median SEPs (m-SEPs) in three patients who underwent CM resection (surgery) near the sensory-motor cortex. The only preoperative clinical manifestations in all patients were seizures. Read More

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Pulse-train versus single-pulse t-EMG stimulation for intraoperative neurophysiologic monitoring of thoracic pedicle screws in adolescent idiopathic scoliosis.

Clin Neurol Neurosurg 2022 04 11;215:107207. Epub 2022 Mar 11.

Spine Unit, Hospital La Fraternidad, Madrid, Spain.

Objective: To assess the PTS method in neuromonitoring of thoracic pedicle screws in a young cohort of AIS patients. The accuracy of both PTS (Pulse-train stimulation) and SPS (Single-pulse stimulation) techniques in the detection of misplaced thoracic screws was compared with special reference to the screws placed at the concavity and the convexity of the curve.

Patients And Methods: A single-center prospective clinical cohort study. Read More

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Does the Use of Surgical Adjuncts Affect Postoperative Infection Rates in Neuro-oncology Surgery?

World Neurosurg 2022 Jun 6;162:e246-e250. Epub 2022 Mar 6.

Department of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester, UK.

Background: Surgical site infection (SSI) is a significant cause of postoperative morbidity and mortality. As oncologic care advances, the use of surgical adjuncts such as intraoperative ultrasound (US), 5-aminolevulinic acid (5-ALA), and neurophysiologic monitoring has increased. This study set out to identify whether the use of surgical adjuncts in supratentorial tumor surgery lead to increased operative time or increased rates of SSI. Read More

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Spine Surgery and Ankylosing Spondylitis: Optimizing Perioperative Management.

Clin Spine Surg 2022 Mar 7. Epub 2022 Mar 7.

Department of Neurology Pathophysiology Program Department of Orthopedics, Rheumatology, and Traumatology, School of Medical Science, University of Campinas (UNICAMP), Campinas-SP, Brazil Department of Orthopaedic Surgery & Neurosurgery, Northwestern Spine Health, Northwestern University School of Medicine, Chicago, IL.

Ankylosing spondylitis (AS) is a common form of axial spondyloarthritis, characterized by inflammatory back pain, radiographic sacroiliitis, excess spinal bone formation, and a high prevalence of HLA-B27. Commonly, AS patients require spinal surgery for kyphotic deformities, spinal trauma, and spinal infections. For preoperative management, proper interruption considering each specific half-lives of disease-modifying antirheumatic drugs are necessary to avoid complications, such as infections. Read More

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The utility of intraoperative neurophysiological monitoring in surgical treatment for spinal arteriovenous malformations: A historical control study.

Clin Neurophysiol Pract 2022 3;7:59-64. Epub 2022 Feb 3.

Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Objective: This study sought to investigate the utility of intraoperative neurophysiological monitoring (IONM) in the surgical treatment for spinal arteriovenous malformations (SAVMs).

Methods: We retrospectively reviewed the data of 39 patients who underwent surgical treatment for SAVMs. Twenty-eight patients who received multimodal IONM (transcranial electrical motor-evoked potentials [MEPs], somatosensory-evoked potentials, continuous electromyography, and bulbocavernosus reflex [BCR]) between 2011 and 2020 were compared to 11 historical controls between 2003 and 2011. Read More

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February 2022

Intraoperative neurophysiological monitoring in Latin America: A bibliometric analysis.

J Clin Monit Comput 2022 Mar 2. Epub 2022 Mar 2.

Neurology and Clinical Neurophysiology, Centro de Neurologia de Campinas, Campinas, SP, Brazil.

Purpose: Intraoperative Neurophysiological Monitoring (IOMM) has been used worldwide in the attempt to reduce postsurgical neurological deficits, however, most of the publications are from developed countries. There is a global bibliometric analysis of IOMN in spinal surgery, however, the contribution of Latin America (LA) is not mentioned. The aim of this study is to describe scientific productivity, patterns of publications, and thematic trends of IONM in LA. Read More

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Temporary vessel occlusion in cerebral aneurysm surgery guided by direct cortical motor evoked potentials.

Acta Neurochir (Wien) 2022 05 2;164(5):1255-1263. Epub 2022 Mar 2.

Department of NeurosurgeryZucker School of Medicine at Hofstra/NorthwellThird Floor, Lenox Hill Hospital, 130 East 77th Street, Black Hall Bldg, New York, NY, 10075, USA.

Background: Temporary clipping is an important tool in the vascular neurosurgeon's armamentarium. We routinely utilize intraoperative neurophysiological monitoring (IONM) for complex brain aneurysm surgery cases, relying on direct cortical motor evoked potential (DCMEP) alerts to guide the duration of temporary clipping. Previous studies have argued for relatively short and intermittent temporary clipping strategies. Read More

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