Last modified by Max Gosey on 2010/06/18 15:52
From 24.1 to 25.1
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... ... @@ -20,8 +20,6 @@ 20 20 21 21 = Section IV.4.1: General Uses of Neurological Monitoring in Spine Surgery = 22 22 23 - 24 - 25 25 (% class="FreeForm" style="text-align: justify; line-height: 200%;" %) 26 26 (% style="font-family: ~"Times New Roman~",~"serif~";" %)Intraoperative neurophysiological monitoring has become a routine procedure in complex spine surgery. Somatosensory-evoked potential (SSEP) recording has been advocated to monitor the functional integrity of the nervous system during surgical manipulation [22-24, 35]. When stimulated, sensory afferents give rise to signals, carried via the dorsal columns (DC), within the spinal cord to the medial lemniscus and spinocerebellar tracts, ending in the primary somatosensory cortex [4]. SSEP monitoring does not involve the motor pathways, which in some clinical situations can lead to false-negative results and postoperative neurological deficits undetected intraoperatively [1-3, 5, 6, 7, 12]. Dermatomal SSEP testing allows for assessment of individual nerve roots during surgery and has been shown to be more sensitive [7, 8]. However, the sensitivity and specificity of this method varies and is less well-liked than electromyographic (EMG) monitoring [8, 9]. EMG has become the standard of practice in complex spine surgery, providing surgeons with accurate feedback about individual nerve root activity during surgical manipulation of neural structures [10-14]. 27 27 ... ... @@ -267,6 +267,7 @@ 267 267 268 268 269 269 268 + 270 270 = Section IV.4.4: New frontiers of intraoperative EMG application = 271 271 272 272 (% class="FreeForm" style="text-align: justify; line-height: 200%;" %)