Neurophysiological Monitoring Symposium!

Coming Up....!

I just came back from Clearwater, FL after two days of intensive and elaborate symposium on Nueorphysiological monitoring organized by the American Society of Neurophysiological Monitoring (ASNM).

It was quite an insightful symposium participated by neuromonitoring specialists from all over US, almost all the speakers of this meeting were the most renowned and well known in this field.

......................can't wait to hear my experience and views on this meeting.......?. Ooooohhh, Clearwater's beach is beautiful, beautiful and the weather was just incredeble last weekend!.

What's New in Pediatric Orthopaedics???- Review by Kim and Noonan

In the latest issue of the journal JB and JS,  authours Young-Jo Kim, MD, PhD¹ 

and Kenneth J. Noonan, MD published their reviews on"Pediatric Orthopaedics". 

They discuss about the recent advancements in the field of Pediatric Orthopadics 

with emphasis on various spine deformity, neurological disorders in childrens with 

appropirate surgical methods used. They have done an excellent review of the literature, 

the 82 references listed can be useful for those in the Pediatric Ortho as well as for 

Neurophysiologists. There is a section on basic science applications and in another 

section on spine, they talk about effectiveness of Intraoperative monitoring 

using motor evoked potentials.

The effectiveness of spinal cord monitoring during spinal deformity surgery was recently reported in two large studies (involving >1000 patients), with the incidence of spinal cord injury approaching 1%^66,67. Transcranial motor-evoked potentials are exquisitely sensitive to threatened spinal cord function, andtheir use together with traditional somatosensory evoked potentials improves the accuracy of spinal cord monitoring. Somatosensory evoked potentials may not detect all problems and may not detect problems as rapidly as transcranial motor-evoked potentials do⁶⁷, and the sensitivity of transcranial motor-evoked potentials has led some centers to abandon somatosensory evoked potentials in favor of motor monitoring alone. For instance, Hsu et al.⁶⁸ reported 100% sensitivity for the detection of a clinically important neurological event in a consecutive series of 144 patients. The authors defined a neurological event as either a new postoperative deficit or a 50% decrease in the monitoring potential over a one-minute period. The rapidity with which motor monitoring detects spinal cord compromise makes it a valuable tool for sagittal plane correction, and prompt detection of a problem can lead to its resolution before a permanent deficit results^69,70.

The Journal of Bone and Joint Surgery (American). 2009;91:743-751.doi:10.2106/JBJS.H.01689