Utility of Electromyography for Nerve Root Monitoring During Spinal Surgery

Nichols, Grant S.; Manafov, Elmar

doi:10.1097/wnp.0b013e31824cece6

Cited by 29 publications

(11 citation statements)

References 98 publications

(126 reference statements)

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“…A recording time base of 200–1000 msec/division is used. Several distinct firing patterns of S-EMG activity may be recorded [ 29 , 93 ], and the surgeon should be able to identify them by sound [ 94 ]. While the sound of EMG activity may serve to heighten the surgeon's awareness, not all patterns of EMG activity are cause for concern and attempting to differentiate EMG patterns by sound alone is inadvisable.…”

Section: Methodsmentioning

confidence: 99%

Intraoperative Neurophysiological Monitoring for Endoscopic Endonasal Approaches to the Skull Base: A Technical Guide

Singh

Vogel²,

Lober

et al. 2016

Scientifica

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Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base. The modalities employed include electroencephalography, somatosensory evoked potentials, free-running and electrically triggered electromyography, transcranial electric motor evoked potentials, and auditory evoked potentials. Methodological considerations as well as benefits and limitations are discussed. The authors argue that, while individual modalities have their limitations, multimodality neuromonitoring provides a real-time, comprehensive assessment of nervous system function and allows for safer, more aggressive management of skull base tumors via the endonasal route.

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Section: Methodsmentioning

confidence: 99%

Intraoperative Neurophysiological Monitoring for Endoscopic Endonasal Approaches to the Skull Base: A Technical Guide

Singh

Vogel²,

Lober

et al. 2016

Scientifica

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“…EMG may also be unreliable at estimating a distance from a nerve as higher values may not always correspond to a safe zone, and it cannot reliably monitor sensory-specific nerves. 6,[24][25][26][27][28] Given these limitations, several studies have concluded that the use of only EMG for IONM during LLIF is likely inadequate and there may be a high rate of postoperative nerve complications in the setting of normal IONM EMG readings (Table 1). 10,11,29,30…”

Section: Electromyographymentioning

confidence: 99%

Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion

et al. 2021

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Objective: To review the evidence for the use of electromyography (EMG), motor-evoked potentials (MEPs), and somatosensory-evoked potentials (SSEPs) intraoperative neuromonitoring (IONM) strategies during lateral lumbar interbody fusion (LLIF), as well as discuss the limitations associated with each technique.Methods: A comprehensive review of the literature and compilation of findings relating to clinical studies investigating the efficacy of EMG, MEP, SSEP, or combined IONM strategies during LLIF.Results: The evidence for the use of EMG is mixed with some studies demonstrating the efficacy of EMG in preventing postoperative neurologic injuries and other studies demonstrating a high rate of postoperative neurologic deficits with EMG monitoring. Multimodal IONM strategies utilizing MEPs or saphenous SSEPs to monitor the lumbar plexus may be promising strategies based on results from a limited number of studies.Conclusion: The use of traditional EMG during LLIF remains without consensus. There is a growing body of evidence utilizing multimodal IONM with MEPs or saphenous SSEPs demonstrating a possible decrease in postoperative neurologic injuries after LLIF. Future prospective studies, with clear definitions of neurologic injury, that evaluate different multimodal IONM strategies are needed to better assess the efficacy of IONM during LLIF.

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“…[236][237][238] Collectively, these 3 articles should provide a nice introduction to the subject for anesthesiology residents. [236][237][238] Collectively, these 3 articles should provide a nice introduction to the subject for anesthesiology residents.…”

Section: Monitoringmentioning

confidence: 99%

Neuroanesthesiology Update

Pasternak¹,

Lanier²

2013

Journal of Neurosurgical Anesthesiology

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We provide a review of both clinical and basic science literature from 2012 relevant to care of the patient with neurological disease. Our review addresses the following major areas: general neurosurgical procedures, stroke, traumatic brain injury, spine surgery, anesthetic neurotoxicity, neuroprotective strategies, electrophysiological monitoring, history, and graduate medical education. We have focused on research describing new and innovative concepts and recurring themes. This review is intended to be of interest to those working in the clinical arena and also to neuroscientists.

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Utility of Electromyography for Nerve Root Monitoring During Spinal Surgery

Cited by 29 publications

References 98 publications

Intraoperative Neurophysiological Monitoring for Endoscopic Endonasal Approaches to the Skull Base: A Technical Guide

Intraoperative Neurophysiological Monitoring for Endoscopic Endonasal Approaches to the Skull Base: A Technical Guide

Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion

Neuroanesthesiology Update

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