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Eur Spine J 2018 Dec 17. Epub 2018 Dec 17.

Spine Unit, Department of Neurology, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland.

Purpose: We compared the value of different uni- and multimodal intraoperative neurophysiological monitoring (IONM) methods on the detection of neurological complications during spine surgery.

Methods: IONM data derived from sensory spinal and cortical evoked potentials combined with continuous electromyography monitoring, motor evoked potentials and spinal recording were evaluated in relation to subsequent post-operative neurological changes. Patients were categorised based on their true-positive or true-negative post-operative neurological status. Read More

Clin Exp Otorhinolaryngol 2018 Dec 11. Epub 2018 Dec 11.

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

Objectives: False-negative or false-positive responses in intraoperative neuromonitoring (IONM) using electromyography (EMG) in thyroid surgery pose a challenge. Therefore, we developed a novel IONM system that uses a surface pressure sensor instead of EMG to detect muscle twitching. This study aimed to investigate the feasibility and safety of a new IONM system using a piezo-electric surface pressure sensor in an experimental animal model. Read More

J Neurosurg Spine 2018 Nov 1:1-9. Epub 2018 Nov 1.

OBJECTIVEThe purpose of this study was to evaluate the technical feasibility, accuracy, and relevance on surgical outcome of D-wave monitoring combined with somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) during resection of intradural extramedullary (IDEM) spinal tumors.METHODSClinical and intraoperative neurophysiological monitoring (IONM) data obtained in 108 consecutive patients who underwent surgery for IDEM tumors at the Institute for Scientific and Care Research "ASMN" of Reggio Emilia, Italy, were prospectively entered into a database and retrospectively analyzed. The IONM included SSEPs, MEPs, and-whenever possible-D-waves. Read More

World Neurosurg 2018 Nov 26. Epub 2018 Nov 26.

Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Dexmedetomidine (DEX) is used as an adjunct to total intravenous anesthesia. However, its effect on intraoperative neurophysiological monitoring (IOM) during brain tumor surgery remains controversial. The aim of this study was to explore the effect of DEX on IOM during brain tumor surgery. Read More

Acta Neurochir (Wien) 2018 Nov 27. Epub 2018 Nov 27.

Department of Surgical Specialties, Division of Neurosurgery and Unit of Neurophysiopathology, San Filippo Neri Hospital/ASLRoma1, Via Reno 14, 00198, Rome, Italy.

Background And Objective: Goals of small vestibular schwannoma (VS) microneurosurgery are as follows: radical resection, facial nerve (FN) preservation, and hearing preservation (HP). Microsurgical advances make HP possible in many patients with preoperative socially useful hearing (SUH). We evaluated postoperative HP in VS with maximum diameter < 2 cm monitored with two different auditory brainstem response (ABR) techniques. Read More

Cureus 2018 Sep 22;10(9):e3346. Epub 2018 Sep 22.

Neurophysiology, Axis Neuromonitoring, Richardson, USA.

Arthroscopic hip surgery is performed routinely for the treatment of various hip disorders. Leg traction during labral tear repair, femoroplasty, and acetabuloplasty for hip stabilization can stretch the peripheral nerves. This may cause temporary or permanent nerve injury. Read More

Front Pediatr 2018 1;6:309. Epub 2018 Nov 1.

Department of Neurosurgery, Alder Hey NHS Foundation Trust, Liverpool, United Kingdom.

Pediatric neuro-oncology surgery continues to progress in sophistication, largely driven by advances in technology used to aid the following aspects of surgery: operative planning (advanced MRI techniques including fMRI and DTI), intraoperative navigation [preoperative MRI, intra-operative MRI (ioMRI) and intra-operative ultrasound (ioUS)], tumor visualization (microscopy, endoscopy, fluorescence), tumor resection techniques (ultrasonic aspirator, micro-instruments, micro-endoscopic instruments), delineation of the resection extent (ioMRI, ioUS, and fluorescence), and intraoperative safety (neurophysiological monitoring, ioMRI). This article discusses the aforementioned technological advances, and their multimodal use to optimize safe pediatric neuro-oncology surgery. Read More

Conf Proc IEEE Eng Med Biol Soc 2018 Jul;2018:3894-3897

The purpose of this study was to develop a user-friendly presentation of surface-EMG data in near-time for intraoperative nerve-monitoring. We have built a novel surface-EMG probe as a diagnostic device to investigate innervation patterns of sphincter muscles in further clinical diagnostic studies. S-EMG data were recorded from 20 healthy volunteers from the orbicularis oris muscles. Read More

BMC Anesthesiol 2018 Nov 7;18(1):161. Epub 2018 Nov 7.

Department of Paediatric Anaesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.

Background: The Auditory brainstem implant (ABI) is a new surgical option for hearing impaired children. Intraoperative neurophysiology monitoring includes brainstem mapping of cranial nerve (CN) IX, X, XI, XII and their motor nuclei, and corticobulbar tract motor-evoked potential. These require laryngeal electrodes and intra-oral pins, posing a challenge to airway management especially in the pediatric airway, where specialized electromyogram (EMG) tracheal tubes are not available. Read More

World Neurosurg 2018 Nov 1. Epub 2018 Nov 1.

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

Background: There is still a controversy for low-flow extracranial-intracranial (EC-IC) or high-flow EC-IC bypass with proximal occlusion in the treatment of unclippable giant internal carotid artery aneurysms.

Case Description: A 61-year-old woman presented with a one-month history of double vision. Neuroimages revealed an unclippable giant internal carotid artery aneurysm located from the cavernous sinus to proximal site of the posterior communicating artery. Read More

Neurodiagn J 2018 2;58(4):218-225. Epub 2018 Nov 2.

a Division of Surgical Neurophysiology Keck Hospital of University of Southern California , Los Angeles , California.

Transcranial electrical motor evoked potential (TcMEP) is a modality utilized in intraoperative neurophysiological monitoring to assess the integrity of the corticospinal tract. Traditionally, TcMEPs are obtained by anodal stimulation of the scalp over the motor cortex of the selected hemisphere and referenced to the contralateral hemisphere. Subsequent compound motor action potential responses (CMAPs) are recorded at various muscles. Read More

Brain Tumor Res Treat 2018 Oct;6(2):60-67

Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Background: Recently, modern technology such as diffusion tensor imaging (DTI), neuro-navigation and intraoperative neurophysiological monitoring (IOM) have been actively adopted for the treatment of thalamic tumors. We evaluated surgical outcomes and efficacy of the aforementioned technologies for the treatment of pediatric thalamic tumors.

Methods: We retrospectively reviewed clinical data from 37 children with thalamic tumors between 2004 and 2017. Read More

J Clin Monit Comput 2018 Oct 30. Epub 2018 Oct 30.

Golden Gate Neuromonitoring, San Francisco, CA, USA.

The American Society of Neurophysiological Monitoring (ASNM) was founded in 1989 as the American Society of Evoked Potential Monitoring. From the beginning, the Society has been made up of physicians, doctoral degree holders, Technologists, and all those interested in furthering the profession. The Society changed its name to the ASNM and held its first Annual Meeting in 1990. Read More

Neurosurg Rev 2018 Oct 26. Epub 2018 Oct 26.

Department of Neurosurgery, Inselspital, Bern University Hospital, 3010, Bern, Switzerland.

In vestibular schwannoma (VS) surgery postoperative facial nerve (CN VII) palsy is reducing quality of life. Recently, we have introduced a surgical suction device for continuous dynamic mapping to provide feedback during tumor resection without switching to a separate stimulation probe. The objective was to evaluate the reliability of this method to avoid CN VII injury. Read More

J Clin Neurophysiol 2018 Nov;35(6):463-467

Clinical Neurophysiology Department, Hospital Ramón y Cajal, Madrid, Spain.

Purpose: The occurrence of urinary incontinence and erectile dysfunction after surgical treatment for prostate cancer is a significant and lingering problem. The aim of this study is to revise and improve older techniques of intraoperative cavernous nerve mapping already in use to improve accuracy and reliability.

Methods: We prospectively studied this technique in 12 patients suffering from prostate cancer. Read More

Asian J Neurosurg 2018 Jul-Sep;13(3):595-606

Department of Neurosurgery-Neurotraumatology, A.O.U. Parma, Parma, Italy.

Objective And Background: Data on intraoperative neurophysiological monitoring (IOM) during surgery of spinal dural arteriovenous fistulas (SDAVFs) are lacking. The purpose of this study was to evaluate the role of IOM during microsurgery for SDAVFs.

Materials And Methods: From March 2007 to March 2013, 12 patients had microsurgery with IOM for SDAVFs. Read More

Neurosurg Focus 2018 Oct;45(VideoSuppl2):V7

Department of Neurological Surgery, University of Wisconsin-Madison School of Medicine and Public Health; and.

Although the surgical treatment of thalamic tumors remains challenging due to the proximity to the internal capsule, safe resection of gliomas or metastatic tumors of the thalamus are possible in some selected cases due to a better understanding of microsurgical anatomy and due to advances in neurophysiological mapping and monitoring. In this video, the authors demonstrate the use of mapping of the internal capsule with direct subcortical stimulation for the resection of a metastatic tumor. The patient is a 58-year-old man with a history of renal cell carcinoma and metastasis in the left thalamus and parieto-occipital region. Read More

Curr Oncol Rep 2018 Sep 26;20(11):89. Epub 2018 Sep 26.

Department of Neurosurgery, Stanford University, 300 Pasteur Dr, Stanford, CA, 94305, USA.

Purpose Of Review: Surgical treatment of brain tumors remains an integral part of a comprehensive treatment plan. Here, we review technological advances that have enhanced what surgeons are capable of doing within and outside the traditional operating room.

Recent Findings: Extent of surgical resection has improved with the use of MRI and fluorescent dyes intraoperatively. Read More

Neurodiagn J 2018 ;58(3):174-181

b Department of Neurology , Duke University Medical Center , Durham , North Carolina.

Somatosensory evoked potentials (SEPs) using tibial nerve stimulation are used during neurophysiologic intraoperative monitoring (NIOM). These SEPs produce a P37 waveform that is recorded from scalp electrodes. In this study, we attempted to determine the best derivation for recording the P37 waveform. Read More

Surg Neurol Int 2018 3;9:177. Epub 2018 Sep 3.

Federal Centre of Treatment and Rehabilitation of Ministry of Healthcare of Russian Federation, 125367 Moscow, Russia.

Background: The use of awake craniotomy for surgical treatment of epilepsy was applied in surgery of convexital tumors, arteriovenous malformations, some superficial aneurysms, and stereotactic neurosurgery. The aim of this study was to show the advantages of awake craniotomy without sedation, accompanied by intraoperative neurophysiological monitoring in patients with symptomatic epilepsy.

Methods: This article describes the results of surgical treatment in 41 patients with various pathologies; 31 among them suffered from epilepsy. Read More

Clin Neurophysiol 2018 Nov 22;129(11):2276-2283. Epub 2018 Aug 22.

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

Objective: To identify factors associated with the failure to generate baseline muscle motor evoked potentials (mMEPs) during spinal surgery, and to determine the association between baseline mMEP generation and postoperative outcomes.

Methods: A total of 345 patients who underwent spine surgery with intraoperative mMEP monitoring were included, and we retrospectively reviewed their demographic/clinical parameters, and mMEP recording results according to lesion locations.

Results: Multivariable logistic regression analysis revealed that preoperative Medical Research Council grade of the weakest muscle <3 was significantly associated with failure of baseline mMEP generation in both cervical and thoracic lesions. Read More

BMC Neurol 2018 Sep 14;18(1):142. Epub 2018 Sep 14.

Department of Neurosurgery, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya, China.

Background: Patients with ischemic cerebrovascular diseases are more likely to suffer from intracranial aneurysms, and their surgical treatment has a growing controversy in this condition. The current case series was aimed at exploring surgical treatment and perioperative management of intracranial aneurysms in Chinese patients with ischemic cerebrovascular diseases.

Methods: Minimally invasive surgical approach through small pterion or inferolateral forehead was applied in 31 patients. Read More

Clin Neurophysiol 2018 Nov 29;129(11):2245-2251. Epub 2018 Aug 29.

Graduate School of Business and Law School, Stanford University, USA; Hoover Institution, Stanford University, USA.

Objectives: Well-designed longitudinal studies assessing effectiveness of intraoperative neurophysiologic monitoring (IONM) are lacking. We investigate IONM effects on cost and administrative markers for health outcomes in the year after cervical spine surgery.

Methods: We identified single-level cervical spine surgeries in commercial claims. Read More

World Neurosurg 2018 Oct 2;118:e304-e315. Epub 2018 Jul 2.

Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, Bangalore, India.

Objective: To evaluate the safety and accuracy of anatomic- and lateral fluoroscopic-guided placement of C2 pars/pedicle, C1 lateral mass screws, and freehand placement of C2 laminar screws.

Methods: All the patients who underwent posterior cervical/occipitocervical fixation that involved the placement of C1/C2 screws during a 5-year period (2011-2015) at our institute were included in this study.

Results: C1/C2 screws were placed in a total of 94 patients during this period. Read More

J Korean Neurosurg Soc 2018 Sep 31;61(5):625-632. Epub 2018 Aug 31.

Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.

Objective: Because the anatomical structure of the brachial plexus is very complex, surgical treatment of tumors in this region is challenging. Therefore, a lot of clinical and surgical experience is required for successful treatment; however, many neurosurgeons have difficulty accumulating this experience owing to the rarity of brachial plexus tumors. The purpose of this report is to share our surgical experience with brachial plexus tumor with other neurosurgeons. Read More

Acta Neurochir Suppl 2018;129:43-52

Division of Neurosurgery, Padua City Hospital, Padova, Italy.

Intraoperative flowmetry (IF) has been recently introduced during cerebral aneurysm surgery in order to obtain a safer surgical exclusion of the aneurysm. This study evaluates the usefulness of IF during surgery for cerebral aneurysms and compares the results obtained in the joined surgical series of Verona and Padua to the more recent results obtained at the neurosurgical department of Verona.In the first surgical series, between 2001 and 2010, a total of 312 patients were submitted to IF during surgery for cerebral aneurysm at the neurosurgical departments of Verona and Padua: 162 patients presented with subarachnoid hemorrhage (SAH) whereas 150 patients harbored unruptured aneurysms. Read More

J Neurosurg Sci 2018 Aug 28. Epub 2018 Aug 28.

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

Background: Decompression and, when necessary, neurolysis in entrapment neuropathies of upper limbs are effective and safe procedures, but their correlation with the variation of compound muscle action potentials (CMAPs) is still unclear, based in particular on experimental models. In addition, there are few data regarding the efficacy of intraoperative neurophysiologic monitoring (IOM) to predict clinical early and late outcome after surgery in term of pain control and sensitive/motor recovery. We report about the association between the intraoperative anatomical and neurophysiological findings and the mid- and long-term postoperative clinical course in a surgical series. Read More

World Neurosurg 2018 Nov 16;119:e1052-e1059. Epub 2018 Aug 16.

Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan.

Objective: We investigated the relationship between the reliability of the transcranial or transcortical motor evoked potential (MEP) response and age in pediatric patients aged ≤15 years with brain tumor.

Methods: We retrospectively analyzed the data from 60 consecutive patients aged ≤15 years who had undergone brain tumor surgery that involved intraoperative MEP monitoring from October 2009 to May 2016.

Results: A total of 41 patients with reliable signals (MEP response group) and 19 patients without reliable signals (MEP nonresponse group) were included in the present study. Read More

J Shoulder Elbow Surg 2018 Oct 13;27(10):1845-1851. Epub 2018 Aug 13.

New England Baptist Hospital, Boston, MA, USA; Boston Sports and Shoulder Center, Waltham, MA, USA. Electronic address:

Hypothesis: Grammont-style reverse shoulder arthroplasty (RSA) has an increased risk of nerve injury compared with anatomic total shoulder arthroplasty (TSA) due to arm lengthening. We hypothesized that an RSA with a lateralized glenosphere and 135° neck-shaft angle would reduce humeral lengthening and decrease the risk of nerve injury to the level of a TSA.

Methods: The study prospectively enrolled 50 consecutive patients undergoing RSA (n = 30) or TSA (n = 20) as determined by a power analysis based on previous research for our institution. Read More

Spine (Phila Pa 1976) 2018 09;43(17):1231-1237

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Study Design: Retrospective study.

Objective: The goal of the study was to investigate the significance of a change in latency in monitoring of transcranial muscle-action potential (Tc-MsEP) waveforms.

Summary Of Background Data: Tc-MsEP has become a common approach in spine surgery due to its sensitivity and importance in motor function. Read More

Acta Neurochir (Wien) 2018 Oct 8;160(10):1963-1974. Epub 2018 Aug 8.

Neurosurgery Department, Hospital Universitari de Bellvitge, Feixa Llarga s/n, 09807, Hospitalet de Llobregat, Barcelona, Spain.

Background: Eloquent area surgery has become safer with the development of intraoperative neurophysiological monitoring and brain mapping techniques. However, the usefulness of intraoperative electric brain stimulation techniques applied to the management and surgical treatment of cavernous malformations in supratentorial eloquent areas is still not proven. With this study, we aim to describe our experience with the use of a tailored functional approach to treat cavernous malformations in supratentorial eloquent areas. Read More

J Anesth 2018 Oct 4;32(5):702-708. Epub 2018 Aug 4.

Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.

Purpose: To provide optimal conditions for neurophysiological monitoring and rapid awakening, remifentanil is commonly used during pediatric spinal surgery. However, remifentanil may induce hyperalgesia and increase postoperative opioid requirements. We evaluated the potential of methadone or magnesium to prevent remifentanil-induced hyperalgesia. Read More

Clin Neurophysiol 2018 Oct 20;129(10):2075-2082. Epub 2018 Jul 20.

Neurophysiology and Evoked Potentials, Hospital Vithas 9 d́Octubre, C/ de la Vall de la Ballestera 59, 46015 Valencia, Spain.

Objective: Our objective is to use the area of the motor evoked potential (MEP) as a diagnostic tool for intraoperative radicular injury.

Methods: We analyzed the intraoperative neurophysiological monitoring data and clinical outcomes of 203 patients treated for dorsolumbar spine deformity. The decrease in amplitude was compared with the reduction in the MEP area. Read More

World Neurosurg 2018 Nov 1;119:30-39. Epub 2018 Aug 1.

Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan.

Objective: Extended margin tumor resection beyond the abnormal area detected by magnetic resonance imaging, defined as supratotal resection, could improve the outcomes of patients with lower grade gliomas (LGGs). The aim of the present study was to assess the surgical outcomes of awake brain mapping to achieve supratotal resection with determination of the normal brain tissue boundaries beyond the tumor of frontal LGGs, in both dominant and nondominant hemispheres.

Methods: We analyzed the data from 9 patients with diffuse frontal LGGs who had undergone supratotal resection with awake surgery from January 2016 to November 2017. Read More

Spine (Phila Pa 1976) 2018 08;43(16):1154-1160

Neurosurgeon - State University of Campinas (UNICAMP), Campinas-SP, Brazil.

Study Design: Systematic literature review and meta-analysis.

Objective: The objective of this systematic literature review was to evaluate if intraoperative neurophysiological monitoring (IONM) can prevent neurological injury during spinal operative surgical procedures.

Summary Of Background Data: IONM seems to have presumable positive effects in identifying neurological deficits. Read More

Asian Spine J 2018 Aug 27;12(4):678-685. Epub 2018 Jul 27.

Fulya Orthopaedic and Spine Center, İstanbul, Turkey.

Study Design: A retrospective clinical study.

Purpose: To analyze the surgical outcomes of intraoperative halo-femoral traction (HFT) in patients with adolescent idiopathic scoliosis (AIS) with Cobb angles between 70° and 90° and flexibility <35%.

Overview Of Literature: Numerous methods have been described to achieve adequate correction and successful results in the surgical treatment of AIS patients with a Cobb angle >70°. Read More

World Neurosurg 2018 Oct 27;118:290-295. Epub 2018 Jul 27.

Department of Neurosurgery, Hôpital Gui de Chauliac, Montpellier University Medical Center, Montpellier, France; INSERM U1198, University of Montpellier, Montpellier, France.

Background: Bow hunter's syndrome is a symptomatic vertebrobasilar insufficiency resulting from a rotational stenosis or occlusion of a dominant vertebral artery (VA). The VA is dynamically compressed by cervical osteoarthritis (discovertebral structure or osteophytes) during head rotation or neck extension. Diagnosis is based on dynamic computed tomography angiography and confirmed with dynamic catheter angiography. Read More

World Neurosurg 2018 Oct 25;118:269-273. Epub 2018 Jul 25.

Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.

Background: Difficulties are associated with the diagnosis and management of patients with coma because of intracranial hypotension.

Case Description: A 70-year-old man with coma (Glasgow Coma Scale score of 6) with fixed dilated pupils because of severe intracranial hypotension is described. After unsuccessful epidural blood patch (EBP), the patient underwent microsurgical dural repair and drainage of hematoma with intracranial pressure (ICP) monitoring. Read More

Neurosurgery 2018 Jul 25. Epub 2018 Jul 25.

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

Background: Spinal cerebrospinal fluid (CSF) leaks are the cause of spontaneous intracranial hypotension (SIH).

Objective: To propose a surgical strategy, stratified according to anatomic location of the leak, for sealing all CSF leaks around the 360° circumference of the dura through a single tailored posterior approach.

Methods: All consecutive SIH patients undergoing spinal surgery were included. Read More

World Neurosurg 2018 Nov 23;119:e235-e243. Epub 2018 Jul 23.

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

Objective: The aim of this study is to determine the risk factors affecting intraoperative neurophysiologic monitoring (IONM) changes, when such changes take place, and clinical outcomes associated with IONM change during cervical open door laminoplasty (COL) for cervical compressive myelopathy.

Methods: Between 2010 and 2015, 79 patients who underwent COL with IONM recording were studied. Changes in motor evoked potentials or somatosensory evoked potentials over an alarm criterion were defined as IONM change. Read More

Int J Neural Syst 2018 Jun 18:1850026. Epub 2018 Jun 18.

2 Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Shinjuku-ku, Tokyo 162-8666, Japan.

Intraoperative neurophysiological monitoring during brain surgery uses direct cortical stimulation to map the motor cortex by recording muscle activity induced by the excitation of alpha motor neurons (MNs). Computational models have been used to understand local brain stimulation. However, a computational model revealing the stimulation process from the cortex to MNs has not yet been proposed. Read More

World Neurosurg 2018 Oct 20;118:246-249. Epub 2018 Jul 20.

Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.

Objective: We sought to study the application of precise intraoperative localization of small intramedullary spinal cord tumors.

Methods: From November 2015 to August 2017, 5 patients with small intramedullary spinal cord tumors were arranged in this group. By using the O-arm image system, we acquired the intraoperative computed tomography images of all patients and sent them to the Stealth navigation system. Read More

World Neurosurg 2018 Oct 18;118:e887-e894. Epub 2018 Jul 18.

Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Seoul, South Korea.

Objective: Although many studies have investigated the benefits of multimodal intraoperative monitoring (MIOM) during cervical spine surgery, the benefits of MIOM in craniovertebral junction (CVJ) surgery remain unclear. The objectives of the present study were to report our clinical experience in CVJ surgery with the use of MIOM and to identify risk factors that could affect MIOM changes during surgery of CVJ pathology.

Methods: We reviewed the MIOM records of 146 patients who had undergone high cervical spinal surgery. Read More

World Neurosurg 2018 Nov 17;119:e94-e105. Epub 2018 Jul 17.

Glioma Surgery Division, Neurological Surgery Department of Huashan Hospital, Fudan University, Shanghai, China.

Objective: To evaluate long-term functional and survival outcomes of patients with glioma after intraoperative neurophysiologic monitoring (IONM) application.

Methods: A total of 856 patients with glioma, who underwent tumor resection between October 2010 and March 2016, were included in this retrospective cohort study. All patients were stratified into IONM (439 patients) and non-IONM groups (417 patients). Read More

Spine J 2018 Jul 17. Epub 2018 Jul 17.

Department of Anesthesia & Perioperative Care, University of California, San Francisco, San Francisco, CA 94143, USA.

Study Design: Case-control analysis of transcranial motor evoked potential (MEP) responses and clinical outcome.

Objective: To determine the sensitivity and specificity of MEPs to predict isolated nerve root injury causing dorsiflexion weakness in selected patients having complex lumbar spine surgery.

Summary Of Background Data: The surgical correction of distal lumbar spine deformity involves significant risk for damage to neural structures that control muscles of ankle and toe dorsiflexion. Read More

J Clin Neurophysiol 2018 Sep;35(5):419-425

Ortho-Spine Research Department, Sint Maartenskliniek, Nijmegen, the Netherlands.

Purpose: In transcranial electrical stimulation, induced motor evoked potentials (MEPs) are influenced by the montage of stimulation electrodes. Differences are to be examined between coronal and sagittal stimulation.

Methods: Forty-five patients with idiopathic scoliosis were included. Read More

Curr Opin Anaesthesiol 2018 Oct;31(5):532-538

Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil.

Purpose Of Review: The purpose of this review is to highlight the importance of making informed choices of anesthetics and evaluating the impact of depth of anesthesia, hemodynamic status and other factors capable of interfering with signal capture during intraoperative neurophysiological monitoring (IONM).

Recent Findings: Over the last decades, neuromonitoring has advanced considerably, allowing for insights into neurological function during anesthesia and making it possible to assess intraoperative consciousness and neural integrity in real time. IONM is indicated in surgeries posing risk to targeted neural tissues and adjacent structures. Read More

J Int Med Res 2018 Oct 17;46(10):4100-4110. Epub 2018 Jul 17.

2 Department of Neurology, Yongchuan Hospital of Traditional Chinese Medicine, Chongqing, China.

Objective To assess the efficacy of cerebrally monitoring the depth of anaesthesia in reducing postoperative cognitive dysfunction and postoperative delirium (POD). Methods MEDLINE, EMBASE, and Cochrane Library databases were searched following PRISMA statement guidelines. We included randomized clinical trials (RCTs) comparing electroencephalogram-based and routine care-guided titration of anaesthesia in a systematic review. Read More

Clin Interv Aging 2018 5;13:1211-1218. Epub 2018 Jul 5.

Department of Rehabilitation Medicine, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Republic of Korea.

Background: Cervical compressive myelopathy (CCM) is a progressive, degenerative spine disease and the most common cause of spinal cord dysfunction in older individuals. Current clinical guidelines for spinal surgery recommend multimodal intraoperative monitoring (IOM) during spinal surgery as a reliable and valid diagnostic adjunct to assess spinal cord integrity. The aim of this study was to evaluate the effect of positive changes during IOM on the functional status in patients with CCM. Read More

J Clin Neurosci 2018 Sep 11;55:71-75. Epub 2018 Jul 11.

Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan. Electronic address:

Objective: The present study aimed to investigate the threshold and distribution of afterdischarges (ADs) with cortical electrical stimulation for functional brain mapping.

Method: We retrospectively analyzed data from 11 patients with medically intractable epilepsy who underwent 50-Hz cortical electrical stimulation for functional mapping followed by resection. These patients became seizure free for more than six months. Read More