Intraoperative neurophysiological monitoring during spinal surgery: technical review in open and minimally invasive approaches.
Neurosurg Rev
; 42(2): 297-307, 2019 Jun.
Article
em En
| MEDLINE
| ID: mdl-29313181
ABSTRACT
Neurophysiological monitoring is of undoubted value for the intraoperative safety of neurosurgical procedures. Widely developed and used for cranial surgery, it is equally as effective, though perhaps less commonly employed, for spinal pathology. The most frequently used techniques for intraoperative monitoring during spinal surgery include somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs) and electromyography, which can either be spontaneous free-running (sEMG) or triggered (tEMG). The knowledge of the benefits and limitations of each modality is essential in optimising the value of intraoperative monitoring during spinal procedures. This review will analyse the single techniques, their anatomical and physiological basis, their use in spinal surgery as reliable indicators of functional injury, their limits and their application to specific procedures in minimally invasive surgery, such as the lateral transpsoas access for interbody fusion and the divergent trajectory for cortico-pedicular screws. In these particular techniques, because of reduced visual exposure, neuromonitoring is indeed essential to exploit the full potential of minimally invasive surgery, while avoiding damage to nervous structures.
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Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Coluna Vertebral
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Procedimentos Neurocirúrgicos
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Monitorização Neurofisiológica Intraoperatória
Limite:
Humans
Idioma:
En
Revista:
Neurosurg Rev
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Itália