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Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
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Neuromonitoring in Spinal Deformity Surgery: A Multimodality Approach.
Joseph L Laratta1, Alex Ha1, Jamal N Shillingford1
1Columbia University Medical Center, The Spine Hospital at New York Presbyterian, New York, NY, USA.
Global Spine Journal
|February 20, 2018
Summary
Intraoperative monitoring is crucial for detecting and managing potential neurologic injuries during vertebral column resection surgery. This review highlights techniques and risk factors to enhance patient safety and surgical outcomes.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neuromonitoring
Background:
- Vertebral column resection (VCR) is a complex spinal surgery.
- Intraoperative monitoring (IOM) is essential for patient safety during VCR.
- Evidence on IOM efficacy in VCR requires comprehensive review.
Purpose of the Study:
- To provide an overview of IOM techniques used in VCR.
- To review the evidence supporting the efficacy of these IOM techniques.
- To discuss risk factors and management strategies for neurologic alarms during VCR.
Main Methods:
- Comprehensive literature review of IOM in VCR.
- Discussion of historical evolution of neuromonitoring modalities.
- Detailed outline of surgical techniques and preferred IOM methods.
Main Results:
- Identified risk factors for signal changes: preoperative deficit, severe kyphosis, increased curve magnitude, cord shortening.
- No evidence-based algorithm for signal changes exists.
- Discussed strategies for preventing and managing neuromonitoring alarms.
Conclusions:
- Multimodal IOM effectively localizes and manages potential neurologic injuries in real time.
- IOM significantly improves safety and outcomes in spinal deformity surgery.
- IOM is a valuable tool for complex spinal procedures like VCR.
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