Influence of the Montage of Stimulation Electrodes for Intraoperative Neuromonitoring During Orthopedic Spine Surgery

Berends, Hanneke I.; Journée, H. L.

doi:10.1097/wnp.0000000000000498

Cited by 5 publications

(2 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Between electrode impedances of 300 and 500 Ω, the relation between impedance and electrode contact surface transits from an uncorrelated independent to a linear relationship, in which the segmental impedance between the electrodes at 2.5 kHz becomes overruled by the local electrode impedance ( Journée et al, 2004 ; Berends and Journée, 2018 ). Only the latter is proportionally related with the electrode contact surface ( Journée et al, 2004 ; Berends and Journée, 2018 ). The finding of a further impedance decrease after 1 h in one horse confirms that the signal quality of surface electrodes further improves after a longer settling time.…”

Section: Discussionmentioning

confidence: 99%

Extramuscular Recording of Spontaneous EMG Activity and Transcranial Electrical Elicited Motor Potentials in Horses: Characteristics of Different Subcutaneous and Surface Electrode Types and Practical Guidelines

Journée

Reed

et al. 2020

Front. Neurosci.

View full text Add to dashboard Cite

Introduction: Adhesive surface electrodes are worthwhile to explore in detail as alternative to subcutaneous needle electrodes to assess myogenic evoked potentials (MEP) in human and horses. Extramuscular characteristics of both electrode types and different brands are compared in simultaneous recordings by also considering electrode impedances and background noise under not mechanically secured (not taped) and taped conditions. Methods: In five ataxic and one non-ataxic horses, transcranial electrical MEPs, myographic activity, and noise were simultaneously recorded from subcutaneous needle (three brands) together with pre-gelled surface electrodes (five brands) on four extremities. In three horses, the impedances of four adjacent-placed surfaceelectrode pairs of different brands were measured and compared. The similarity between needle and surface EMGs was assessed by cross-correlation functions, pairwise comparison of motor latency times (MLT), and amplitudes. The influence of electrode noise and impedance on the signal quality was assessed by a failure rate (FR) function. Geometric means and impedance ranges under not taped and taped conditions were derived for each brand. Results: High coherencies between EMGs of needle-surface pairs degraded to 0.7 at moderate and disappeared at strong noise. MLTs showed sub-millisecond simultaneous differences while sequential variations were several milliseconds. Subcutaneous MEP

show abstract

Section: Discussionmentioning

confidence: 99%

Extramuscular Recording of Spontaneous EMG Activity and Transcranial Electrical Elicited Motor Potentials in Horses: Characteristics of Different Subcutaneous and Surface Electrode Types and Practical Guidelines

Journée

Reed

et al. 2020

Front. Neurosci.

View full text Add to dashboard Cite

show abstract

“…inhalation agents, hypotension, hypoxia, hypothermia) related changes, there are two levels of warning to the surgeon. The first report is done at a 50% loss of response, marked as an “alert”, and the second report is done at 75–80%, marked as an “alarm.” Considering that MEP responses are elicited after a single stimulus, it is sufficient to have 2–3 repeats for intervention and then subsequently at every step of correction until a signal returns at the baseline 5, 6, 7…”

Section: Methodsmentioning

confidence: 99%

Kyphosis – A risk factor for positioning brachial plexopathy during spinal surgeries

Biščević¹,

Sehic²,

Biscevic³

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

View full text Add to dashboard Cite

Objective The aim of this study was to evaluate the differences in transcranial electric motor-evoked potentials – TceMEP on upper limbs and the incidences of postoperative brachial plexopathy between patients with kyphotic and scoliotic trunk shapes. Methods In the period of January 2011–January 2017, 61 consecutive patients (mean age: 18.4 years ± 4.4 years (range: 10–32)) with pediatric spinal deformity underwent surgery in our Department. Eight of them had a kyphotic trunk deformity (Scheuermann kyphosis, neurofibromatosis, posterior thoracic hemivertebra), and the rest of the 53 patients had a scoliotic trunk deformity (mostly adolescent idiopathic scoliosis – AIS, lateral hemivertebra). The TceMEP recordings in all four limbs were analyzed every 30 min, or upon the surgeon's command. Upper limb TceMEP recordings were used as a control of systemic and anesthetic related changes, and as the indicator of positioning brachial plexopathy. Results Four out of 8 patients (50.0%) from the kyphotic group experienced noteworthy decreases in TceMEP amplitude (≥65%) in one or both arms, and only 2 out of 53 patients (3.8%) from the scoliotic group, confirming significant statistical difference (Chi-square 16.75, p < 0.05). Two out of 8 patients with decreases in TceMEP amplitude suffered from transitory postoperative brachial plexopathy, and both of them were from the kyphotic group. Conclusion It seems that kyphotic trunks have a higher risk for positioning-related brachial plexopathy, probably due to distribution of trunk's weight onto only four points (two iliac bones and two shoulders), compared to the scoliotic trunks that have wider weight-bearing areas. We emphasize the importance of proper patient positioning and close intraoperative neuro-monitoring of all four limbs in more than one channel per limb. Level of Evidence Level IV Therapeutic Study.

show abstract

Safety issues during surgical monitoring

Journée

Shils

2022

Intraoperative Neuromonitoring

View full text Add to dashboard Cite

Influence of the Montage of Stimulation Electrodes for Intraoperative Neuromonitoring During Orthopedic Spine Surgery

Abstract: Biphasic stimulation at C3C4 is advised when constant voltage stimulation is used to monitor the spinal cord during orthopedic spine surgery. MTvoltage of corkscrew and small needle electrodes are highly sensitive to electrode impedances.

Cited by 5 publications

References 28 publications

Extramuscular Recording of Spontaneous EMG Activity and Transcranial Electrical Elicited Motor Potentials in Horses: Characteristics of Different Subcutaneous and Surface Electrode Types and Practical Guidelines

Extramuscular Recording of Spontaneous EMG Activity and Transcranial Electrical Elicited Motor Potentials in Horses: Characteristics of Different Subcutaneous and Surface Electrode Types and Practical Guidelines

Kyphosis – A risk factor for positioning brachial plexopathy during spinal surgeries

Safety issues during surgical monitoring

Contact Info

Product

Resources

About