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Hyper Smash
Showing posts with label SSEPs. Show all posts
Showing posts with label SSEPs. Show all posts

Monday, May 17, 2010

American Academy of Neurology-Policy on Intraoperative Neuromonitoring!

The American Academy of Neurology has put up this policy on Intraoperative Neuromonitoring, though old but it is interesting note some observations like the following multicenter evaluation study on SSEPs, it is an impressive result as far as SSEPs concerned.
2. Multicenter Data in Spinal Surgeries
An extensive multicenter study conducted in 1995 demonstrated that IOM using SEP reduced the
risk of paraplegia by 60% in spinal surgeries (Nuwer et al., 1995). The incidence of false
negative cases, wherein an operative complication occurred without having been detected by the
monitoring procedure, was small: 0.06% (Nuwer et al., 1995).

Sunday, September 14, 2008

Ulnar Neuropathy? If the surgery site is lower Lumosacral level, why should you monitor upper limp SSEPs?

This article in the latest Spine Journal (an electronic publication) demonstrates that upper limp SSEP monitoring is quite handy in detecting ulnar nerve neuropathy during lower back surgeries??.

PubMed-NCBI Spine J. 2008 Aug 4. [Epub ahead of print]Click here to read Upper-limb somatosensory evoked potential monitoring in lumbosacral spine surgery: a prognostic marker for position-related ulnar nerve injury.

BACKGROUND CONTEXT: Somatosensory evoked potential (SSEP) is used to monitor integrity of the brain, spinal cord, and nerve roots during spinal surgery. It records the electrical potentials from the scalp after electrical stimulation of the peripheral nerves of the upper or lower limbs. The standard monitoring modality in lumbosacral spine surgery includes lower-limb SSEP and electromyography (EMG). Upper-limb SSEP monitoring has also been used to detect and prevent brachial plexopathy and peripheral nerve injury in thoracic and lumbosacral spine surgeries. We routinely monitor lower-limb SSEP and EMG in lumbosacral spine procedures at our institution. However, a few patients experienced postoperative numbness and/or pain in their ulnar distribution with uneventful lower-limb SSEP and EMG.