WHITE PLAINS, N.Y. /New York Netwire/ — Spinal surgery involves a wide variety of complex procedures, according to N.Y.-based Neuro Alert. There is a potential for major neurological deficits if they are not recognized during surgery, so effective corrective action can be taken quickly. It goes without saying that early detection of potential complications is crucial for patient safety.
Therefore, any tool or technique that can prevent or reduce the rate of intraoperative injuries holds tremendous appeal for patients and surgeons alike.
In recent years, there has been an increasing interest in intraoperative neurophysiological neuromonitoring (IONM) procedures designed to alert surgeons of potential damage to the nervous system during surgery, and help them rectify the situation. Real time monitoring assists surgeons and anesthesiologists with assessing neural structures, including the neuromuscular junction, peripheral nerve, spinal cord, brainstem, and cerebral cortex. Conducted by an on-site technician and remote interpreting physician, IONM can make spinal surgeries safer and prevent neurological deficits and/or morbidity.
Why is IONM so Important?
Oftentimes, spinal surgery involves the following procedures:
1) Decompression of the spinal nerve roots and/or the spinal cord.
2) The use of instrumentation (i.e. plates, screws, rods, cages, etc.).
3) Deformity Correction (Scoliosis, Kyphosis, spondylolisthesis).
Possible complications may include damage to the spinal cord and nerve roots. As a result, the patient can develop radiculopathy (spinal nerve root injury) or myelopathy (spinal cord injury).
Traditionally, surgeons have relied on X-rays and computed tomography (CT) scans to check the placement of hardware during surgery.
“Unfortunately, imaging techniques do not always identify improperly placed hardware, damage to nerve tissue, or small fractures of certain parts of vertebra,” says Dr. T.V. Seshan, the founder and clinical director of Neuro Alert, a Westchester N.Y.-based healthcare organization providing neuromonitoring services for surgeons, surgical groups and hospitals.
“Evidence suggests that IONM has proven to be more effective in instantly spotting certain types of neurological damage. Furthermore, it is easy-to-use and cost-efficient. IONM is commonly used for spinal fusion, total disc replacement, scoliosis, kyphosis, spondylolisthesis, pain stimulator placement, spinal tumor resection, and other treatment procedures.”
How Does it Work? When a patient undergoes spinal surgery, a monitoring technician places wire electrodes on his/her limbs. Electrodes are also placed on the surface of the skull, over the area of the brain that receives the impulse from the limb. A technician uses sophisticated equipment to monitor the electrical activity along the peripheral nerves, spinal cord and in the brain.
This activity is being recorded as wave form and used throughout the whole procedure. Any significant change in the wave forms prompts the surgeon that there might be potential damage to the neuromuscular system. That’s when the surgical team can take immediate action, averting irreversible injury or post-operative complications.
In addition, IONM serves as a better and more reliable alternative to the neurological evaluation when a patient is under anesthesia and not capable of undergoing face-to-face examination. In fact, it may be dangerous to wake up patients suffering from serious conditions. Some individuals may negatively respond to the wake-up test, due to age or mental status. Besides, it can lengthen the time of surgery and does not properly evaluate nerve function.
“During spinal surgery, the key blood vessels, nerve roots and spinal cord are deemed to be at risk for serious injury,” adds Dr. T.V. Seshan. “As spinal surgeries continue to evolve and minimally invasive procedures become more prevalent in the surgical field, it is quite likely that the value and significance of neuromonitoring will continue to grow. We are hoping that eventually IONM will become a routine part of all neurosurgical procedures where the neurological structures may be at risk of injury.”
Due to the fact that intraoperative monitoring is a critical tool for assessing the nervous system, every member of the monitoring team should undergo intense training and develop the experience needed for this challenging job. The monitoring team usually consists of neurophysiology technologists and interpreting physicians who perform live remote monitoring to provide instant feedback on a patient’s condition and effectively coordinate the process with the surgical team.
About Neuro Alert
Neuro Alert is a physician-owned and operated company providing intraoperative neurophysiological monitoring (IONM) services for surgeons, surgical groups and hospitals since 2006. The rapidly-growing Westchester N.Y.-based organization was founded by Dr. T.V. Seshan – a renowned physician, specializing in physical medicine and rehabilitation, who has been actively involved in intraoperative monitoring over the course of 30 years.
The simple yet crucial monitoring procedures, offered by Neuro Alert, are set up to detect any neurological deficits during major surgeries, allowing surgeons to gain instant feedback about their patient’s condition and avert potential adverse affects.
Neuro Alert consists of a team of experienced and highly-skilled physicians and technical professionals who work together to enhance treatment precision, reduce physician liability and ensure patient safety. For more information about Neuro Alert, please visit http://neuroalert.com/ or call (888) 787-6267.
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