Electromagnetic Navigation Systems and Intraoperative Neuromonitoring: Reliability and Feasibility Study

Area of Science:

• Neurosurgery
• Medical Technology
• Neurophysiology

Background:

• The integration of new intraoperative technologies in neurosurgery is increasing.
• Limited studies evaluate the combined accuracy and safety of simultaneous technologies.

Purpose of the Study:

• To evaluate the feasibility of using an electromagnetic navigation system concurrently with multimodal intraoperative neurophysiological monitoring (IONM).

Main Methods:

• A prospective cohort study involving 15 patients undergoing craniotomy for brain tumor resection.
• Utilized an electromagnetic navigation system (AxiEM) and recorded motor evoked potentials, SSEPs, EEG, and EMG.
• Analyzed IONM data with the navigation system on and off, applying software filters and adjusting physical setups to mitigate noise.

Main Results:

• Raw IONM data showed electromagnetic field interference, particularly in SSEPs.
• No significant differences in SSEP morphology, amplitude, or latency were observed after applying software filters.
• Postoperative outcomes showed no new deficits, with 7 patients experiencing motor deficit improvement.

Conclusions:

• IONM provides reliable data for monitoring, mapping, and detecting complications in neurosurgery patients using electromagnetic navigation systems.
• Effective use requires appropriate software filters, stimulation adjustments, and optimized equipment configuration.