Intraoperative neurophysiological monitoring in spinal cord tumor surgery

Abstract

Once a spinal cord tumor (SCT) is detected, it is usually removed surgically. During this process, intraoperative neurophysiological monitoring (IONM) is widely performed to detect neural insults of the spinal cord early and prevent neurological complications after surgery. This review article introduces the basic concepts and setting of the major modalities, somatosensory evoked potentials, motor evoked potentials, and direct wave and discusses the precautions, alarm criteria, and reliability associated with IONM during SCT surgery. This review emphasizes that multimodal monitoring improves the reliability of the IONM and that it is important that an experienced professional examiner continuously monitor these surgeries.

Diagnostic Accuracy of Somatosensory Evoked Potential and Transcranial Motor Evoked Potential in Detection of Neurological Injury in Intradural Extramedullary Spinal Cord Tumor Surgeries: A Short-Term Follow-Up Prospective Interventional Study Experience from Tertiary Care Center of India

“…There is a consensus to continue the surgery, as long as MEP recordings are stable. 9 10 The role of IONM in IMSCT surgeries has been highlighted in various studies; however, its routine use in IDEMSCT and extradural SCT is still under debate. 5 10…”

“…9 10 The role of IONM in IMSCT surgeries has been highlighted in various studies; however, its routine use in IDEMSCT and extradural SCT is still under debate. 5 10…”

The feasibility of intra-operative neurophysiologic monitoring using rectus abdominis muscles during thoracic tumor surgery: a case report

“…척추 수술에서 수술중신경계감시(intraoperative neurophysiologic monitoring, IONM)의 유용성은 잘 알려져 있 다 [1]. 특히 척수종양에서의 IONM은 수술 중 신경 손상 또는 허혈성 손상을 조기에 발견하고 수술 후 신경학적 악화를 예 방하기 위해 널리 사용되고 있으며 [2], 그 민감도와 특이도 또 한 높다고 알려져 있다 [3]. 특히 척수종양 수술에서 운동유발 전위(motor evoked potentials, MEPs)는 체성감각유발전위 (somatosensory evoked potentials, SEPs)보다 수술 후 운 동 악화(post-operative motor deterioration)에 대한 특이 도가 높다고 알려져 있으며 [4], 통상적으로 MEP는 전경골근 (tibialis anterior), 엄지발가락 벌림근(abductor halluces) 등을 이용하여 측정한다 [5].…”

The efficacy of intraoperative neuromonitoring, including triggered electromyography, in intradural extramedullary spine tumors: a successful case study

“…Furthermore, these modalities are employed for mapping to identify neural structures, facilitating selective surgical approaches. There are existing evidences which support the efficacy of these modalities during the spinal surgery, including spinal cord tumor, spinal deformity, and degenerative diseases [2,3,4].…”