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Multimodality Intraoperative Neurophysiological Monitoring (IONM) During Shoulder Surgeries.

Faisal R Jahangiri1, James Blaylock1, Nida Qadir1

  • 1Axis Neuromonitoring LLC , Richardson, Texas.

The Neurodiagnostic Journal
|April 17, 2020
PubMed
Summary
This summary is machine-generated.

Intraoperative Neurophysiological Monitoring (IONM) detected potential nerve injuries during shoulder surgery in 30% of patients. Multimodality IONM can help prevent nerve damage and deficits by alerting surgeons to real-time signal changes.

Keywords:
ArthroscopyIONMlatarjet procedureopen reductionshoulder surgery

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Neurophysiology

Background:

  • Nerve injuries can occur during shoulder surgery.
  • Intraoperative Neurophysiological Monitoring (IONM) is a technique used to detect and prevent such injuries.

Purpose of the Study:

  • To evaluate the role of IONM in identifying and preventing nerve damage during shoulder surgery.
  • To assess the effectiveness of multimodality IONM in real-time nerve injury detection.

Main Methods:

  • Retrospective analysis of IONM data from ten shoulder procedures.
  • Utilized bilateral Somatosensory Evoked Potentials (SSEP), Transcranial Motor Evoked Potentials (TCeMEP), Electromyogram (EMG), and Train of Four (TOF) recordings.
  • Analyzed signal changes and patient outcomes.

Main Results:

  • IONM detected impending nerve injury in 30% of patients, with signal decreases noted in three individuals.
  • One patient experienced deficits despite IONM, attributed to severe blood loss.
  • Successful triggered EMG (t-EMG) recordings were achieved in 71.4% of patients.

Conclusions:

  • Multimodality IONM can identify real-time nerve injury during shoulder surgery.
  • IONM may have prevented nerve injury in 30% of cases in this series.
  • Utilizing IONM can help minimize nerve injury frequency and associated deficits.