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01-06-2019 | Review

Intraoperative neurophysiological monitoring during spinal surgery: technical review in open and minimally invasive approaches

Authors: Fabio Cofano, Francesco Zenga, Marco Mammi, Roberto Altieri, Nicola Marengo, Marco Ajello, Paolo Pacca, Antonio Melcarne, Carola Junemann, Alessandro Ducati, Diego Garbossa

Published in: Neurosurgical Review | Issue 2/2019

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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Title: Intraoperative neurophysiological monitoring during spinal surgery: technical review in open and minimally invasive approaches
Authors: Fabio Cofano
Francesco Zenga
Marco Mammi
Roberto Altieri
Nicola Marengo
Marco Ajello
Paolo Pacca
Antonio Melcarne
Carola Junemann
Alessandro Ducati
Diego Garbossa
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Published in: Neurosurgical Review / Issue 2/2019
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-017-0939-4

At a glance: The STEP trials

Springer Medicine

Intraoperative neurophysiological monitoring during spinal surgery: technical review in open and minimally invasive approaches

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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