1,906 results match your criteria Intraoperative Neurophysiological Monitoring


Application of an Intraoperative Neuromonitoring System Using a Surface Pressure Sensor in Parotid Surgery: A Rabbit Model Study.

Clin Exp Otorhinolaryngol 2020 Jul 7. Epub 2020 Jul 7.

Department of Otolaryngology-Head and Neck Surgery, Pusan National University Hospital, College of Medicine and Medical Research Institute, Busan, Korea.

Objectives: Facial nerve monitoring (FNM) can be used to identify the facial nerve, to obtain information regarding its course, and to evaluate its status during parotidectomy. However, there has been disagreement regarding the efficacy of FNM in reducing the incidence of facial nerve palsy during parotid surgery. Therefore, instead of using electromyography (EMG) to identify the location and state of the facial nerve, we applied an intraoperative neuromonitoring (IONM) system using a surface pressure sensor to detect facial muscle twitching. Read More

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http://dx.doi.org/10.21053/ceo.2019.01900DOI Listing

Motor evoked potentials during revascularization in ischemic stroke predict motor pathway ischemia and clinical outcome.

Clin Neurophysiol 2020 Jun 18. Epub 2020 Jun 18.

Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Objective: The relevance of motor evoked potential (MEP) recovery during mechanical endovascular thrombectomy (MT) in patients with ischemic stroke is unclear. We correlated MEP recovery during MT to symptom improvement and to ischemia in eloquent motor areas on magnetic resonance imaging (MRI) and compared the predictive value of MEPs to visual angiographic reperfusion status, classified by modified Thrombolysis in Cerebral Infarction grading (mTICI).

Methods: Patients with hemisyndrome and large-vessel occlusion undergoing MT were included (n35, 49% females; 73. Read More

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http://dx.doi.org/10.1016/j.clinph.2020.05.026DOI Listing

Cautionary findings for motor evoked potential monitoring in intracranial aneurysm surgery after a single administration of rocuronium to facilitate tracheal intubation.

J Clin Monit Comput 2020 Jul 2. Epub 2020 Jul 2.

Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 East Huron St, F5-704, Chicago, IL, 60611, USA.

Administration of rocuronium to facilitate intubation has traditionally been regarded as acceptable for intraoperative motor evoked potential (MEP) monitoring because of sufficiently rapid spontaneous neuromuscular blockade recovery. We hypothesized that residual neuromuscular blockade, in an amount that could hinder optimal neuromonitoring in patients undergoing intracranial aneurysm clipping, was still present at dural opening. We sought to identify how often this was occurring and to identify factors which may contribute to prolonged blockade. Read More

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http://dx.doi.org/10.1007/s10877-020-00551-6DOI Listing

Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations.

World Neurosurg X 2020 Jul 28;7:100073. Epub 2020 Feb 28.

Neurosurgery Department, Humanitas Clinical and Research Hospital, Milan, Italy.

Lumbar spinal stenosis (LSS) is defined as a degenerative disorder showing a narrowing of the spinal canal. The diagnosis is straightforward in cases with typical neurogenic claudication symptoms and unequivocal imaging findings. However, not all patients present with typical symptoms, and there is obviously no correlation between the severity of stenosis and clinical complaint. Read More

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http://dx.doi.org/10.1016/j.wnsx.2020.100073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322797PMC

Use of intraoperative neurophysiological monitoring during epiduroscopy as a safety measure.

Clin Neurophysiol Pract 2020 1;5:118-124. Epub 2020 Jun 1.

Neurophysiology Department, Hospital Universitario Quirónsalud Madrid, C/ Diego de Velázquez, 1 28223; Pozuelo de Alarcón, Madrid, Spain.

Objective: In this study, we present the first 12 cases of the use of intraoperative neurophysiological monitoring (IONM) during therapeutic epiduroscopy in patients with clinical canal stenosis.

Methods: IESS was performed using two working instruments: an epidural balloon to dilate the epidural space without damaging the nerve structures (Resaloon®) and an element to perform flavotomy of the ligamentum flavum (Resaflex®). The procedure was performed at levels of the greatest stenosis, as detected using preoperative magnetic resonance imaging. Read More

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http://dx.doi.org/10.1016/j.cnp.2020.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322361PMC

A Protocol Entry Catalog for Intraoperative Neuromonitoring - Steps Towards an Ontology.

Stud Health Technol Inform 2020 Jun;272:318-321

Department of Neurosurgery, Inselspital, University Hospital, Bern, Switzerland.

In neurosurgery, intraoperative neurophysiological monitoring (IOM) with continuous measurements of neural electrical activity may reduce the risk of postoperative deficits. During an IOM, surgical information as well as neurophysiological, surgical and anesthesia events have to be recorded. So far, there is no common standard for this task available. Read More

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http://dx.doi.org/10.3233/SHTI200559DOI Listing

Transient retinal ischemia during carotid endarterectomy estimated by intraoperative visual evoked potential monitoring: Technical note.

World Neurosurg 2020 Jun 24. Epub 2020 Jun 24.

Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.

Objective: Carotid revascularization surgery is known to carry a risk of postoperative visual deterioration associated with retinal ischemia. We checked intraoperative visual evoked potential (VEP) monitoring in carotid endarterectomy (CEA).

Methods: Consecutive 10 patients, who underwent CEA in Shinshu University Hospital under total intravenous anesthesia, were checked by intraoperative VEP and electroretinogram (ERG) recording in addition to SEP monitoring. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.130DOI Listing

Frequency distribution in intraoperative stimulation-evoked EMG responses during selective dorsal rhizotomy in children with cerebral palsy-part 1: clinical setting and neurophysiological procedure.

Childs Nerv Syst 2020 Jun 23. Epub 2020 Jun 23.

Division of Pediatric Neurosurgery, Universitätsklinikum Bonn, 53127, Bonn, Germany.

Introduction: Selective dorsal rhizotomy (SDR) consists of microsurgical partial deafferentation of sensory nerve roots (L1-S2). It is primarily used today in decreasing spasticity in young cerebral palsy (CP) patients. Intraoperative monitoring (IOM) is an essential part of the surgical decision-making process, aimed at improving functional results. Read More

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http://dx.doi.org/10.1007/s00381-020-04734-zDOI Listing

Difficult extubation of a damaged neural integrity monitor electromyogram tracheal tube: A case report.

Medicine (Baltimore) 2020 Jun;99(25):e20250

Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Introduction: The purpose of a neural integrity monitor electromyogram (EMG) tracheal tube is to reduce the risk of damage to the recurrent laryngeal nerves. Complications associated with the use of EMG tube are ventilatory failure, tracheal injury, and difficult extubation.

Patient Concerns: We encountered a case of difficult extubation of an EMG tube after thyroidectomy and partial tracheal resection in a 73-year-old woman. Read More

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http://dx.doi.org/10.1097/MD.0000000000020250DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310868PMC

Barriers of neurophysiology monitoring in spine surgery: Latin America experience.

Surg Neurol Int 2020 30;11:130. Epub 2020 May 30.

Department of Neurosurgery, University of Caxias do Sul, Caxias do Sul, Rio Grande do Sul, Brazil.

Background: Intraoperative neurophysiological monitoring (IOM) has become valuable in spine surgery. Unfortunately, it is not always available in many spine centers, especially in developing countries. Our aim was to evaluate the accessibility and barriers to IOM in spine surgery in Latin America. Read More

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http://dx.doi.org/10.25259/SNI_44_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294159PMC

Neuroanesthesia Guidelines for Optimizing Transcranial Motor Evoked Potential Neuromonitoring During Deformity and Complex Spinal Surgery: A Delphi Consensus Study.

Spine (Phila Pa 1976) 2020 Jul;45(13):911-920

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ.

Study Design: Expert opinion-modified Delphi study.

Objective: We used a modified Delphi approach to obtain consensus among leading spinal deformity surgeons and their neuroanesthesiology teams regarding optimal practices for obtaining reliable motor evoked potential (MEP) signals.

Summary Of Background Data: Intraoperative neurophysiological monitoring of transcranial MEPs provides the best method for assessing spinal cord integrity during complex spinal surgeries. Read More

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http://dx.doi.org/10.1097/BRS.0000000000003433DOI Listing

Intraoperative neurophysiological monitoring in aneurysm clipping: Does it make a difference? A systematic review and meta-analysis.

Clin Neurol Neurosurg 2020 May 29;196:105954. Epub 2020 May 29.

Neurosurgery Unit, Department of Biomedical, Metabolic, and Neuroscience, University of Modena and Reggio Emilia, AOU, Modena, Italy.

The use of intraoperative neurophysiological monitoring (IOM) has been proposed to prevent new neurological deficit during aneurysm clipping. The purpose of this meta-analysis was to evaluate if IOM can prevent neurological injury during clipping of intracranial aneurysm. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analysis, we reviewed clinical comparative studies who evaluate the rate of new neurological deficit in patients who had a surgical clipping with and without IOM. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105954DOI Listing

Intraspinal epidermoid and dermoid cysts-tumor resection with multimodal intraoperative neurophysiological monitoring and long-term outcome.

Acta Neurochir (Wien) 2020 Jun 10. Epub 2020 Jun 10.

Neurosurgical Clinic, Clinic of the University of Munich (Ludwig Maximilians University), Campus Grosshadern, Marchioninistrasse 15, D-81377, Munich, Germany.

Background: Intraspinal epidermoid/dermoid cysts are very rare, benign tumors arising from pathological displacement of epidermal cells into the spinal canal. Literature data about the long-term outcome after microsurgical resection with multimodal intraoperative neurophysiological monitoring (IONM) are lacking. We analyzed one of the largest case series with special regard to intraoperative characteristics and long-term outcome after IONM-aided surgery. Read More

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http://dx.doi.org/10.1007/s00701-020-04446-yDOI Listing

Efficacy of Transcartilaginous Electrodes for Intraoperative Neural Monitoring During Thyroid Surgery.

Clin Exp Otorhinolaryngol 2020 Jun 5. Epub 2020 Jun 5.

Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.

Objectives.: This study was conducted evaluate the efficacy of electromyography (EMG) using transcartilaginous (TC) electrodes through the thyroid cartilage and perichondrium.

Methods. Read More

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http://dx.doi.org/10.21053/ceo.2019.01529DOI Listing

Total hip arthroplasty using the direct anterior approach and intraoperative neurophysiological monitoring for Crowe III hip dysplasia : surgical technique and case series.

Acta Orthop Belg 2020 Mar;86(1):22-27

Developmental dysplasia of the hip with a high dislocation may lead to severe hip pain and a marked shortening. Nerve palsy rates following THA in dysplastic hips have been reported as being higher by ten times or more compared to the general population. We report a new technique to perform THA in high congenital dislocations. Read More

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Neurophysiological monitoring of spinal cord function during spinal deformity surgery: 2020 SRS neuromonitoring information statement.

Spine Deform 2020 May 25. Epub 2020 May 25.

Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.

The Scoliosis Research Society has developed an updated information statement on intraoperative neurophysiological monitoring of spinal cord function during spinal deformity surgery. The statement reviews the risks of spinal cord compromise associated with spinal deformity surgery; the statement then discusses the various modalities that are available to monitor the spinal cord, including somatosensory-evoked potentials, motor-evoked potentials, and electromyographic (EMG) options. Anesthesia considerations, the importance of a thoughtful team approach to successful monitoring, and the utility of checklists are also discussed. Read More

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http://dx.doi.org/10.1007/s43390-020-00140-2DOI Listing

Accuracy of t-EMG stimulation of the middle pedicle track to prevent radiculopathies as a result of misplaced lumbar screws.

Clin Neurol Neurosurg 2020 May 19;195:105915. Epub 2020 May 19.

Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, 46001 Valencia, Spain. Electronic address:

Objective: To describe the accuracy of middle pedicle track stimulation for the detection of pedicle breaches causing misplaced lumbar screws and subsequent neurological symptoms.

Patients And Methods: In a comparative observational study with two cohorts, 1440 lumbar pedicle screws were implanted using the freehand technique in 242 patients undergoing surgery for spinal deformities. In the first two-year period (2011-2012), the accuracy of screw placement (802 screws) was assessed by conventional intraoperative palpation of the pedicle track, t-EMG screw stimulation, and fluoroscopic monitoring. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105915DOI Listing

Microsurgical Resection of a C1-C2 Dumbbell and Ventral Cervical Schwannoma: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2020 May 23. Epub 2020 May 23.

Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee.

Dumbbell schwannoma of the cervical spine is a known entity,1-5 and should be radically resected with the preservation or improvement of neurological function. However, to our knowledge, an operative video of a C1-C2 cervical dumbbell schwannoma with ventral extension and dorsal spinal cord compression has not been reported previously. This tumor resection video performed by the senior author (KIA) includes details of dural opening, and techniques for microsurgical resection and for postoperative closure to avoid cerebrospinal fluid (CSF) leak and pseudomeningocele formation. Read More

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http://dx.doi.org/10.1093/ons/opaa138DOI Listing

Intraoperative neurophysiological monitoring during scoliosis surgery in patients with Duchenne muscular dystrophy.

Eur Spine J 2020 May 21. Epub 2020 May 21.

Department of Neurosurgery, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.

Purpose: Little is known about the reliability and value of intraoperative neurophysiological monitoring (IONM) in patients with Duchenne muscular dystrophy (DMD) undergoing scoliosis correction surgery. The aim of this study was to investigate the feasibility of IONM and the cortical excitability in these patients.

Methods: Fifteen patients with DMD and scoliosis and 15 patients with adolescent idiopathic scoliosis (AIS) underwent scoliosis correction surgery with the use of IONM. Read More

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http://dx.doi.org/10.1007/s00586-020-06458-9DOI Listing

Peripheral leg ischemia detected via intraoperative neurophysiological monitoring during a multilevel complex anterior and posterior operation.

J Surg Case Rep 2020 May 18;2020(5):rjaa049. Epub 2020 May 18.

Division of Orthopaedic Surgery, University of Manitoba, Winnipeg, Canada.

Intraoperative neurophysiologic monitoring is a technique utilized during spinal operations to minimize sensory and motor function morbidity. We herein report a case of a 73-year-old female with renal cell carcinoma and metastatic involvement of the cervical and thoracic spine, who underwent a multilevel complex anterior and posterior operation. Neurophysiological monitoring was able to localize the lower limb ischemia utilizing somatosensory evoked potentials. Read More

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http://dx.doi.org/10.1093/jscr/rjaa049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232934PMC

Result of awake surgery for pediatric eloquent brain area tumors: single-center experience.

Childs Nerv Syst 2020 May 21. Epub 2020 May 21.

Psychological Service, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus.

Purpose: About half of brain tumors are located in supratentorial regions and 20% of them in eloquent brain cortex areas. The use of fMRI and intraoperative neuromonitoring allows safe surgery of these areas. Carrying out awake brain surgery (ABS) operations provides additional opportunities for direct-function monitoring. Read More

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http://dx.doi.org/10.1007/s00381-020-04666-8DOI Listing

Motor evoked potential recovery with surgeon interventions and neurologic outcomes: A meta-analysis and structural causal model for spine deformity surgeries.

Clin Neurophysiol 2020 Jul 12;131(7):1556-1566. Epub 2020 Apr 12.

Intraoperative Monitoring, Department of Neurophysiology, Abbott Northwestern Hospital, 800 E 28th Street, Minneapolis, MN 55407, USA.

Objective: To improve estimates of motor evoked potential (MEP) performance during spine deformity surgeries by accounting for potential confounders.

Methods: A meta-analysis of MEPs for spine deformity surgeries determined the probability of a MEP deterioration which recovered by the end of surgery, P(RSC), and the conditional probability of no new post-operative deficit given an RSC, P(NND|RSC), stratified by category of intraoperative adverse event associated with the MEP deterioration. A structural causal model (SCM) and propensity score matching accounted for intraoperative adverse events and patient diagnosis as potential confounders. Read More

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http://dx.doi.org/10.1016/j.clinph.2020.03.024DOI Listing

DREZotomy in the treatment of deafferentation pain: review of results and analysis of predictive factors for success.

Neurocirugia (Astur) 2020 May 3. Epub 2020 May 3.

Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.

Background And Objectives: The treatment of deafferentation pain by spinal DREZotomy is a proven therapeutic option in the literature. In recent years, use of DREZotomy has been relegated to second place due to the emergence of neuromodulation therapies. The objectives of this study are to demonstrate that DREZotomy continues to be an effective and safe treatment and to analyse predictive factors for success. Read More

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http://dx.doi.org/10.1016/j.neucir.2020.02.007DOI Listing
May 2020
0.322 Impact Factor

Awake surgery for skills preservation during a sensory area tumor resection in a clarinet player.

Acta Neurol Belg 2020 May 5. Epub 2020 May 5.

University of Ferrara, Ferrara, Italy.

Tumors in primary sensory area are challenging to remove without causing a neurological deficit, especially in musicians who present complex neuronal networks. Indeed, in this kind of patients, somatosensory evoked potentials (SSEPs) are not plenty. We describe our experience for sensory and proprioception preservation in a professional clarinet player undergoing surgery for a right parietal glioblastoma. Read More

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http://dx.doi.org/10.1007/s13760-020-01368-5DOI Listing

Continuous Laryngeal Adductor Reflex Versus Intermittent Nerve Monitoring in Neck Endocrine Surgery.

Laryngoscope 2020 May 4. Epub 2020 May 4.

Department of Intraoperative Neurophysiology, Mount Sinai West Hospital, New York, NY, USA.

Objective: Intraoperative neuromonitoring (IONM) techniques aim to identify and potentially prevent nerve injury during surgeries. Prior studies into the efficacy of recurrent laryngeal nerve (RLN) IONM convey mixed results, with some claiming equivalence between IONM and no monitoring at all. The goal of the current study was to compare continuous RLN monitoring using the laryngeal adductor reflex (LAR) to intermittent RLN monitoring (intermittent IONM) to determine whether continuous monitoring reduces the incidence of intraoperative RLN injury during neck endocrine surgeries. Read More

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http://dx.doi.org/10.1002/lary.28710DOI Listing

High-Definition 4K 3D Exoscope (ORBEYETM) in Peripheral Nerve Sheath Tumor Surgery: A Preliminary, Explorative, Pilot Study.

Oper Neurosurg (Hagerstown) 2020 May 1. Epub 2020 May 1.

Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.

Background: Surgery for peripheral nerve sheath tumors aims to preserve functional fascicles achieving gross-total resection. Increasing the visualization of anatomic details helps to identify the different layers and the tumor-nerve interface. The traditional microscope can present some limitations in this type of surgery, such as its physical obstruction. Read More

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http://dx.doi.org/10.1093/ons/opaa090DOI Listing

Clinical Outcomes of Intraoperative Contrast-Enhanced Ultrasound Compared with Intraoperative Neurophysiological Monitoring During Circumferential Decompression for Myelopathy Associated with Thoracic-Ossification of the Posterior Longitudinal Ligament.

Med Sci Monit 2020 Apr 29;26:e921129. Epub 2020 Apr 29.

Orthopedic Department, Peking University Third Hospital, Beijing, China (mainland).

BACKGROUND Circumferential decompression (CD) is an essential treatment option for myelopathy associated with thoracic-ossification of the posterior longitudinal ligament (T-OPLL) when laminectomy cannot achieve sufficient ventral decompression. Although intraoperative neurophysiological monitoring (IONM) is widely used, the operation has a relatively high risk. This study is the first to describe the use of contrast-enhanced ultrasound (CEUS) to evaluate the spinal cord blood flow (SCBF) during thoracic spine surgery in humans. Read More

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http://dx.doi.org/10.12659/MSM.921129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204126PMC

Contralateral Tongue Muscle Activation during Hypoglossal Nerve Stimulation.

Otolaryngol Head Neck Surg 2020 Jun 28;162(6):985-992. Epub 2020 Apr 28.

Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, NewYork Presbyterian Hospital, New York, New York, USA.

Objective: The effectiveness of upper airway stimulation via hypoglossal nerve stimulation for obstructive sleep apnea depends upon the pattern of tongue muscle activation produced. This study investigated the nature of contralateral tongue muscle activation by unilateral hypoglossal nerve stimulation using intraoperative nerve integrity monitoring in conjunction with electromyography and explored the relationship between contralateral tongue muscle activation and polysomnographic measures of obstructive sleep apnea severity.

Study Design: Prospective case series. Read More

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http://dx.doi.org/10.1177/0194599820917147DOI Listing
June 2020
1.721 Impact Factor

Spinal Dysraphism in the Last Two Decades : What I Have Seen during the Era of Dynamic Advancement.

Authors:
Kyu-Chang Wang

J Korean Neurosurg Soc 2020 May 27;63(3):272-278. Epub 2020 Apr 27.

Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea.

Compared to any other decade, the last two decades have been the most dynamic period in terms of advances in the knowledge on spinal dysraphism. Among the several factors of rapid advancement, such as embryology during secondary neurulation and intraoperative neurophysiological monitoring, there is no doubt that Professor Dachling Pang stood high amidst the period. I review here the last two decades from my personal point of view on what has been achieved in the field of spinal dysraphism, focusing on occult tethered cord syndrome, lumbosacral lipomatous malformation, terminal myelocystocele, retained medullary cord, limited dorsal myeloschisis and junctional neural tube defect. Read More

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http://dx.doi.org/10.3340/jkns.2020.0068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218192PMC

Neural Monitoring for Robotic Abdominal Wall Reconstruction.

JSLS 2020 Apr-Jun;24(2)

Physiologic Assessment Services, Teaneck, New Jersey.

Introduction: Positioning-related neural injuries are an inherent risk in surgery, particularly in robotic-assisted abdominal wall reconstruction because of unique patient positioning and increased operative times. The implementation of intraoperative neurophysiological monitoring should be considered in such cases.

Methods: This was a two-armed study with one prospective intervention group and one retrospective control group. Read More

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http://dx.doi.org/10.4293/JSLS.2020.00009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173774PMC

Occipital Plate Fixation in the Pediatric Population.

J Pediatr Orthop 2020 Apr 14. Epub 2020 Apr 14.

Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA.

Background: Occipital plate fixation has been shown to improve outcomes in cervical spine fusion. There is a paucity of literature describing occipital plate fixation, especially in the pediatric population. The authors reviewed a case series of 34 patients at a pediatric hospital who underwent cervical spine fusion with occipital plate fixation between 2003 and 2016. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001564DOI Listing

Multimodality Intraoperative Neurophysiological Monitoring (IONM) During Shoulder Surgeries.

Neurodiagn J 2020 Jun 16;60(2):96-112. Epub 2020 Apr 16.

Department of Orthopedic Surgery, Grace Medical Center , Lubbock, Texas.

The purpose of this study is to identify the advancing role of Intraoperative Neurophysiological Monitoring (IONM) in detecting and preventing nerve injuries during shoulder surgery procedures. We performed a retrospective analysis of IONM data from ten shoulder procedures. The patients consisted of nine females and one male with ages ranging from 67 to 81 years (median: 74 years). Read More

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http://dx.doi.org/10.1080/21646821.2020.1743952DOI Listing

Far Lateral Craniotomy and Occlusion In Situ of a Lateral Medullary Arteriovenous Malformation: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2020 Apr 16. Epub 2020 Apr 16.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Lateral medullary arteriovenous malformations (AVMs) are located in the pia on the lateral medullary surface.1 They are supplied by arterial feeders from the V4 segment of the vertebral artery or posterior inferior cerebellar artery. A 64-yr-old man presented with leg spasms and progressively worsening gait. Read More

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http://dx.doi.org/10.1093/ons/opaa092DOI Listing

Bulbocavernosus Reflex Monitoring During Intramedullary Conus Tumor Surgery.

Cureus 2020 Mar 10;12(3):e7233. Epub 2020 Mar 10.

Neurosurgery, United Regional Health Care System, Wichita Falls, USA.

A T10 to L2 spinal cord tumor exploration and biopsy was performed with intraoperative neurophysiological monitoring (IONM) on a 75-year-old male diagnosed with an intradural intramedullary appearing spinal cord lesion with no other lesions in the central nervous system, chest, abdomen or pelvis. Intraoperative neurophysiology consisted of transcranial electrical motor evoked potentials (TCeMEPs), somatosensory evoked potentials (SSEPs), triggered and spontaneous electromyography (S-EMG, T-EMG), bulbocavernosus reflex (BCR) and train of four (TOF) monitoring. Loss of BCR responses during conus exposure and identification were resolved with multiple small pauses in manipulation throughout the procedure. Read More

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http://dx.doi.org/10.7759/cureus.7233DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145379PMC

Intraoperative monitoring of corticospinal tracts in anterior cervical decompression and fusion surgery: Excitability differentials of lower extremity muscles.

Clin Neurophysiol Pract 2020 10;5:59-63. Epub 2020 Mar 10.

Israel Spine Center, Assuta Medical Center, Tel Aviv, Israel.

Objective: This study examines and compares excitability characteristics of tibialis anterior (TA) and abductor hallucis (AH) transcranial motor evoked potentials (tcMEP) during anterior cervical decompression and fusion (ACDF) surgery.

Methods: Electrophysiological and clinical data of 89 patients who underwent ACDF procedure were retrospectively reviewed. TcMEP data of TA and AH muscles from 178 limbs were analyzed for availability, robustness and stability during the procedure. Read More

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http://dx.doi.org/10.1016/j.cnp.2020.02.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110302PMC

Anterolateral S1 screw malposition detected with intraoperative neurophysiological monitoring during posterior lumbosacral fusion.

Surg Neurol Int 2020 6;11:42. Epub 2020 Mar 6.

Department of Neurosurgery, Hospital Clínico Regional de Concepción, Concepción, Bio-Bio, Chile.

Background: The standard of care is to utilize intraoperative neurophysiological monitoring (IOM) of triggered electromyography (tEMG) during posterior lumbosacral instrumented-fusion surgery. IOM should theoretically signal misplacement of S1 screws into the neural L5-S1 foramen or spinal canal, utilizing screw stimulation, and recording of the lower limb muscles and the anal sphincter. Here, we evaluated when and whether anterolateral S1 screw malposition could be detected by IOM/tEMG during open posterior lumbosacral instrumented fusion surgery. Read More

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http://dx.doi.org/10.25259/SNI_4_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110297PMC

Intraoperative neurophysiology of the cerebellum: a tabula rasa.

Childs Nerv Syst 2020 Jun 3;36(6):1181-1186. Epub 2020 Apr 3.

Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Piazzale Stefani 1, 37124, Verona, Italy.

Purpose: Cerebellar mutism (CM) is a condition that occurs predominantly in children, after posterior fossa surgery (PFS). It is characterized by motor, speech, and behavioral disorders. Despite widespread use of intraoperative neurophysiological monitoring (IONM), little is known about the neurophysiological aspects involved in the pathophysiology of CM. Read More

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http://dx.doi.org/10.1007/s00381-020-04565-yDOI Listing

Pediatric functional hemispherectomy: operative techniques and complication avoidance.

Neurosurg Focus 2020 04;48(4):E9

1Department of Neurological Surgery, University of Washington.

Functional hemispherectomy/hemispherotomy is a disconnection procedure for severe medically refractory epilepsy where the seizure foci diffusely localize to one hemisphere. It is an improvement on anatomical hemispherectomy and was first performed by Rasmussen in 1974. Less invasive surgical approaches and refinements have been made to improve seizure freedom and minimize surgical morbidity and complications. Read More

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http://dx.doi.org/10.3171/2020.1.FOCUS19889DOI Listing

Continuous intraoperative neuromonitoring (cIONM) in head and neck surgery-a review.

HNO 2020 Mar 26. Epub 2020 Mar 26.

Department of Otolaryngology, Head/Neck & Facial Plastic Surgery, Sana Kliniken Leipziger Land, Rudolf-Virchow-Straße 2, 04552, Borna, Germany.

Although the history of intraoperative neuromonitoring (IONM) dates back to the 19th century, the method did not evolve further than the mere differentiation of nerves until recently. Only the development of continuous IONM (cIONM) has allowed for non-stop analysis of excitation amplitude and latency during surgical procedures, which is nowadays integrated into the software of almost all commercially available neuromonitoring devices. The objective of cIONM is real-time monitoring of nerve status in order to recognize and prevent impending nerve injury and predict postoperative nerve function. Read More

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http://dx.doi.org/10.1007/s00106-020-00824-1DOI Listing

Independent Predictors of Perioperative Stroke-Related Mortality after Cardiac Surgery.

J Stroke Cerebrovasc Dis 2020 May 14;29(5):104711. Epub 2020 Mar 14.

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

Background And Purpose: Perioperative stroke remains a devastating complication after cardiac surgery and is associated with significant morbidity and mortality. Despite the significant contribution of stroke to perioperative mortality, risk factors for perioperative stroke-related mortality have not been well characterized. Our aim was to identify independent predictors of perioperative stroke-related mortality after cardiac surgery, using the Pennsylvania Health Care Cost Containment Council (PHC4) database which provides information on cause of death. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104711DOI Listing

[Continuous intraoperative neuromonitoring (cIONM) in head and neck surgery-a review. German version].

HNO 2020 Mar 10. Epub 2020 Mar 10.

Klinik für HNO-Heilkunde, Kopf‑/Hals- und plastische Gesichtschirurgie, Sana Kliniken Leipziger Land, Rudolf-Virchow-Straße 2, 04552, Borna, Deutschland.

Although the history of intraoperative neuromonitoring (IONM) dates back to the 19th century, the method did not evolve further than the mere differentiation of nerves until recently. Only the development of continuous IONM (cIONM) has allowed for non-stop analysis of excitation amplitude and latency during surgical procedures, which is nowadays integrated into the software of almost all commercially available neuromonitoring devices. The objective of cIONM is real-time monitoring of nerve status in order to recognize and prevent impending nerve injury and predict postoperative nerve function. Read More

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http://dx.doi.org/10.1007/s00106-020-00823-2DOI Listing

Application of Attachable Magnetic Nerve Stimulator in Intraoperative Facial Nerve Monitoring during Ear Surgery.

Otolaryngol Head Neck Surg 2020 May 10;162(5):773-775. Epub 2020 Mar 10.

Department of Otorhinolaryngology, College of Medicine, Pusan National University, Busan, Republic of Korea.

We developed an attachable magnetic nerve stimulator (AMNS) that connects the metallic instruments to a neurophysiological monitoring unit for monitoring the facial nerve (FN) during ear surgery and present our experiences with intraoperative neuromonitoring (IONM) of the FN using AMNS. The FN in 20 patients who underwent tympanomastoidectomy for chronic ear disease was examined. The electromyography (EMG) amplitudes of the FN using AMNS were assessed. Read More

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http://dx.doi.org/10.1177/0194599820907912DOI Listing

Neurophysiological Intraoperative Monitoring in the Elderly.

J Clin Neurophysiol 2020 Mar 4. Epub 2020 Mar 4.

Comprehensive Epilepsy Center of Long Island, Port Jefferson, New York, U.S.A.

Introduction: Intraoperative neurophysiological monitoring (IONM) is widely used to prevent nervous system injury during surgeries in elderly patients. However, there are no studies that describe the characteristics and changes in neurophysiological tests during the IONM of patients aged 60 years and older. The study aims to describe and compare IONM changes during surgeries in adult patients aged 18 to 59 years with those aged 60 years and older. Read More

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http://dx.doi.org/10.1097/WNP.0000000000000689DOI Listing

[Evaluation of a Combination of Waveform Amplitude Latency and Decrease of Waveform Amplitude Magnitude during Spinal Surgery in Intraoperative Neurophysiological Monitoring of Transcranial Motor Evoked Potentials and Its Incidence on Postoperative Neurological Deficit].

Acta Chir Orthop Traumatol Cech 2020 ;87(1):39-47

I. Ortopedicko-traumatologická klinika, Lekárskej fakulty Univerzity Komenského, Slovenskej zdravotníckej Univerzity a Univerzitnej nemocnice Bratislava.

PURPOSE OF THE STUDY This retrospective study investigated the significance of a combination of peak latency of waveform amplitude and waveform amplitude in association with spinal deformities. The correlation with postoperative neurologic deficit was evaluated too. MATERIAL AND METHODS Between January 2007 and January 2018, a group of 113 patients was evaluated in the study who underwent spine surgery using intraoperative neurophysiological monitoring (IONM) focusing on transcranial motor evoked potential (tc-MEP) monitoring. Read More

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The efficacy of somatosensory evoked potentials in evaluating new neurological deficits after spinal thoracic fusion and decompression.

J Neurosurg Spine 2020 Mar 6:1-6. Epub 2020 Mar 6.

Departments of1Neurological Surgery and.

Objective: Posterior thoracic fusion (PTF) is used as a surgical treatment for a wide range of pathologies. The monitoring of somatosensory evoked potentials (SSEPs) is used to detect and prevent injury during many neurological surgeries. The authors conducted a study to evaluate the efficacy of SSEPs in predicting perioperative lower-extremity (LE) neurological deficits during spinal thoracic fusion surgery. Read More

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http://dx.doi.org/10.3171/2019.12.SPINE191157DOI Listing

Intraoperative electrophysiology during single-level selective dorsal rhizotomy: technique, stimulation threshold, and response data in a series of 145 patients.

J Neurosurg Pediatr 2020 Feb 28:1-10. Epub 2020 Feb 28.

Departments of1Neurosurgery.

Objective: Selective dorsal rhizotomy (SDR) is effective at permanently reducing spasticity in children with spastic cerebral palsy. The value of intraoperative neurophysiological monitoring in this procedure remains controversial, and its robustness has been questioned. This study describes the authors' institutional electrophysiological technique (based on the technique of Park et al. Read More

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http://dx.doi.org/10.3171/2019.12.PEDS19372DOI Listing
February 2020

Neurophysiologic monitoring for treatment of upper lumbar disc herniation with percutaneous endoscopic lumbar discectomy: A case report on the significance of an increase in the amplitude of motor evoked potential responses after decompression and literature review.

Int J Surg Case Rep 2020 6;67:271-276. Epub 2020 Feb 6.

Department of Paediatrics, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, 518034, China.

Introduction: Intraoperative neurophysiological monitoring (IONM) has been widely used in spinal surgery. There is lack of report about IONM for the treatment of upper lumbar disc herniation (HIVD) with percutaneous endoscopic lumbar discectomy (PELD), the relationship between an immediate increase in amplitude of intraoperative MEP after decompression and improvement of the treated levels is rarely studied. Here we reported a surgical case in which an elderly patient with HIVD underwent PELD with IONM and there was a distinct increase in the amplitude of MEP after decompression, showing an immediate improvement of the treated levels. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.01.042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044662PMC
February 2020

The Impact of Intraoperative Monitoring on Extent of Resection and Long-Term Neurological Outcomes: A Series of 39 Intramedullary Ependimomas.

Turk Neurosurg 2020 ;30(2):252-262

Medical Faculty University of Belgrade, Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, Serbia.

Aim: To analyze the impact of intraoperative neurophysiological monitoring (IONM) on the extent of removal and long-term neurological outcomes in a series of grade II ependymomas.

Material And Methods: We retrospectively reviewed 88 consecutive patients who underwent surgical resection of an intramedullary spinal cord tumor (IMSCT) at the Clinic of Neurosurgery of the Clinical Center of Serbia in Belgrade between January 2012 and December 2017. In all, 39 patients (25 males and 14 females; mean age 46. Read More

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http://dx.doi.org/10.5137/1019-5149.JTN.27471-19.2DOI Listing
January 2020

A Novel Passive Method for the Assessment of Skin-Electrode Contact Impedance in Intraoperative Neurophysiological Monitoring Systems.

Sci Rep 2020 Feb 18;10(1):2819. Epub 2020 Feb 18.

Institute for Research in Technology, ICAI School of Engineering, Pontifical Comillas University, Madrid, Spain.

Intraoperative Neurophysiological Monitoring is a set of monitoring techniques consisting of reading electrical activity generated by the nervous system structures during surgeries. In order to guarantee signal quality, contact impedance between the sensing electrodes and the patient's skin needs to be as low as possible. Hence, monitoring this impedance while signals are measured is an important feature of current medical devices. Read More

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http://dx.doi.org/10.1038/s41598-020-59551-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028911PMC
February 2020