Intraoperative neurophysiologic monitoring in the spine surgery

Abstract

Intraoperative neurophysiologic monitoring (INM) has been growing up as an indispensable method to reduce the risk of the operation-related neuronal damage in various kinds of spine surgeries during the last four decades. To maximize the efficiency of INM, nowadays, many neurophysiologists continue to research the application of the fnovel techniques and the optimization of the existing modalities such as somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), electromyography (EMG), etc. In this article, we review not only the current technique of various INM modalities using in the spine surgery but also the clinical meaning of the INM regarding the diagnostic value for the detection of neural damage during the surgery and the therapeutic value for the decrease of the postoperative neurologic deficits in the spine surgery.

Intraoperative neurophysiological monitoring in spinal cord surgery

“…척수 수술에서 가장 기본적으로 널리 쓰이는 IONM 검사 기법은 체성감각유발전위(somatosensory evoked potential, SSEP), 운동유발전위(motor evoked potential, MEP), 근전 도(electromyography, EMG) 및 망울해면체근반사(bulbocavernous reflex, BCR) 감시 등이 있다 [2,3]. 특히 SSEP 와 MEP는 Level I 권고사항으로 척수 및 척추수술에서 강력 히 권고되고 있다 [4].…”

Intraoperative spinal cord mapping during spinal cord tumor surgery

“…수술 후 신경학 적 결손을 줄이기 위해, 수술중신경계감시(intraoperative neurophysiological monitoring, IONM)가 적극 도입되면 서 척수 수질내 종양에서도 수술 후 신경학적 예후에 IONM의 적용이 긍정적인 효과를 미치는 것으로 여러 연구그룹에 의해 보고되어 왔다 [7][8][9][10]. 거의 대부분의 척추 수술에 기본적으로 적용되는 운동유발전위(motor evoked potentials, MEPs), 체성감각 유발전위(somatosensory evoked potentials, SSEPs), 자유진행 근전도(free-running EMG) 및 병변의 위 치를 고려해 일부 수술에서 추가적으로 시행되는 구해면체근 반사(bulbocavernosus reflex, BCR) 감시 외에도 [11,12], 척수 절개술(myelotomy) 및 수질내 종양 제거 과정에서 각각 뒤기둥(posterior column) 및 피질척수로(corticospinal tract)의 손상을 최소화하기 위한 척수 지도화(spinal cord mapping, SCM) 법도 국외에서는 활용되고 있다 [13][14][15] (3) 정방향 somatosensory evoked potentials(SSEPs) 기록법(위상역전법, phase reversal method)…”

Study on the neurological prognosis of patients who have undergone spinal surgery with intraoperative neurophysiological monitoring in Republic of Korea: a retrospective single center study

“…It was introduced in the 1990s in Republic of Korea (ROK) and has been used in various neurological surgeries, including spine surgery [1]. A variety of devices are used in IONM including somatosensory evoked potential (SSEP), motor evoked potential (MEP), brainstem auditory evoked potential, and visual evoked potential tests, and it also includes free-running and triggered electromyography (EMG) and electroencephalogram [2]. The application of these test methods varies depending on the type of surgery being performed, and SSEP, MEP, and EMG studies are usually required when performing spine surgery [3].…”