Benefits of Neuromonitoring
Most surgeries involving risk to the spine and brain go well and patients recover with little or no morbidity. Unfortunately, the consequences for patients who do suffer iatrogenic injuries can be devastating. Neuromonitoring can prevent or reduce the risks and in some cases, improve the outcome for patients undergoing spine or neuro surgery. Additionally, when a skilled neurophysiologist attends to a patient’s neuro-function, the surgeon may proceed more efficiently given confidence the intervention is not compromising the patient.
There are two functions of a neurophysiologist: preventative and/or interventional.
Preventative neuromonitoring ensures some critical functions are stable, warns the surgeon of impending injury, and offers feedback simultaneously with surgical maneuvers. Examples of preventative neuromonitoring include the following:
Interventional neuromonitoring aids the surgeon in identifying structures critical to the success of the surgery. Examples of interventional neuromonitoring include the following:
Micro-electrode recording to identify the STN for the surgical treatment of Parkinson’s disease with deep brain stimulator implants
Identifying the changes and/or ablation of the ephaptic transmission (or lateral spread) recorded from patients with hemi facial spasm to help identify offending vessels
Impedance testing of pedicle screws for confirming pedicle bone integrity