Neurophysiological monitoring and spinal cord integrity

被引:40
作者
Rabai, Ferenc [1 ]
Sessions, Renard [1 ]
Seubert, Christoph N. [1 ]
机构
[1] Univ Florida, Coll Med, Dept Anesthesiol, POB 100254 JHMHSC,1600 SW Archer Rd,Room M-509, Gainesville, FL 32610 USA
关键词
intraoperative neuromonitoring; somatosensory evoked potentials; motor evoked potentials; electromyography; spinal cord integrity; major spine surgery; intravenous anesthetics; inhalational anesthetics;
D O I
10.1016/j.bpa.2015.11.006
中图分类号
R614 [麻醉学];
学科分类号
100217 [麻醉学];
摘要
An integral part of a major spine surgery is the intraoperative neurophysiological monitoring (IONM). By providing continuous functional assessment of specific anatomic structures, IONM allows the rapid detection of neuronal compromise and the opportunity for corrective action before an insult causes permanent neurological damage. Thus, IONM functions not just as a diagnostic tool but may also improve surgical outcomes. Effective clinical application requires a thorough understanding of the scope and limitations of IONM modalities not only by the monitoring team but also by the surgeon and anesthesiologist. Intraoperatively, collaboration and communication between monitorist, surgeon, and anesthesiologist are critical to the effectiveness of IONM. In this study, we review specific monitoring modalities, focusing on the relevant anatomy, physiology, and mechanisms of neuronal injury during major spine surgery. We discuss how these factors interact with anesthetic and surgical management. This review concludes with the current controversies surrounding the evidence in support of IONM and directions of future research. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:53 / 68
页数:16
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