Intraoperative Neurophysiological Monitoring for Spinal Fusion

Abstract

The surgical techniques of spinal fusion are frequently used in the treatment of many spine conditions. Apart from having anatomical knowledge, in order to perform those procedures safely, it is essential to utilize all the tools available to assure the appropriate positioning of the materials and avoid neural injury. The goal of this article is to review the literature on the use of intraoperative neurophysiological monitoring for spinal fusion procedures and to discuss the controversies regarding this issue.

Resumo

As técnicas cirúrgicas de fusão espinhal são frequentemente utilizadas no tratamento de muitas condições da coluna vertebral. Além do conhecimento anatômico, para realizar esses procedimentos com segurança é essencial utilizar todas as ferramentas disponíveis para assegurar o posicionamento adequado dos materiais e evitar lesões neurais. O objetivo deste artigo é revisar a literatura sobre o uso de monitorização neurofisiológica intraoperatória para procedimentos de fusão espinhal e discutir as controvérsias relacionadas a essa questão.

Keywords

intraoperative neurophysiological monitoring - spinal fusion - review

Palavras-chave

monitorização neurofisiológica intraoperatória - fusão espinhal - revisão

• References

• 1 Elixhauser A, Andrews RM. Profile of inpatient operating room procedures in US hospitals in 2007. Arch Surg 2010; 145 (12) 1201-1208
• 2 Cramer DE, Maher PC, Pettigrew DB, Kuntz IV C. Major neurologic deficit immediately after adult spinal surgery: incidence and etiology over 10 years at a single training institution. J Spinal Disord Tech 2009; 22 (08) 565-570
• 3 Yadla S, Malone J, Campbell PG. , et al. Early complications in spine surgery and relation to preoperative diagnosis: a single-center prospective study. J Neurosurg Spine 2010; 13 (03) 360-366
• 4 Nasser R, Yadla S, Maltenfort MG. , et al. Complications in spine surgery. J Neurosurg Spine 2010; 13 (02) 144-157
• 5 Campbell PG, Yadla S, Malone J. , et al. Complications related to instrumentation in spine surgery: a prospective analysis. Neurosurg Focus 2011; 31 (04) E10
• 6 Ney JP, van der Goes DN, Watanabe JH. Cost-benefit analysis: intraoperative neurophysiological monitoring in spinal surgeries. J Clin Neurophysiol 2013; 30 (03) 280-286
• 7 Welch WC, Rose RD, Balzer JR, Jacobs GB. Evaluation with evoked and spontaneous electromyography during lumbar instrumentation: a prospective study. J Neurosurg 1997; 87 (03) 397-402
• 8 Bilsky MH. . Boachie-Adjei, Shields CB, Baldwin N. Thoracic and lumbar deformities. In: Benzel EC. , editor. Spine surgery: techniques, complication avoidance, and management. Philadelphia: Elsevier Churchill Livingstone; 2005: 796-823
• 9 Pahys JM, Guille JT, D'Andrea LP, Samdani AF, Beck J, Betz RR. Neurologic injury in the surgical treatment of idiopathic scoliosis: guidelines for assessment and management. J Am Acad Orthop Surg 2009; 17 (07) 426-434
• 10 Silva EG, Kojo HD, Joaquim AF, Shaffrey CI. Scoliosis: current overview and treatment considerations. Arq Bras Neurocir 2010; 29 (04) 130-136
• 11 Kulik G, Pralong E, McManus J, Debatisse D, Schizas C. A CT-based study investigating the relationship between pedicle screw placement and stimulation threshold of compound muscle action potentials measured by intraoperative neurophysiological monitoring. Eur Spine J 2013; 22 (09) 2062-2068
• 12 Magit DP, Hilibrand AS, Kirk J. , et al. Questionnaire study of neuromonitoring availability and usage for spine surgery. J Spinal Disord Tech 2007; 20 (04) 282-289
• 13 Fehlings MG, Brodke DS, Norvell DC, Dettori JR. The evidence for intraoperative neurophysiological monitoring in spine surgery: does it make a difference?. Spine 2010; 35 (9, Suppl) S37-S46
• 14 Hamilton DK, Smith JS, Sansur CA. , et al; Scoliosis Research Society Morbidity and Mortality Committee. Rates of new neurological deficit associated with spine surgery based on 108,419 procedures: a report of the scoliosis research society morbidity and mortality committee. Spine 2011; 36 (15) 1218-1228
• 15 Cole T, Veeravagu A, Zhang M, Li A, Ratliff JK. Intraoperative neuromonitoring in single-level spinal procedures: a retrospective propensity score-matched analysis in a national longitudinal database. Spine 2014; 39 (23) 1950-1959
• 16 Garces J, Berry JF, Valle-Giler EP, Sulaiman WA. Intraoperative neurophysiological monitoring for minimally invasive 1- and 2-level transforaminal lumbar interbody fusion: does it improve patient outcome?. Ochsner J 2014; 14 (01) 57-61
• 17 Traynelis VC, Abode-Iyamah KO, Leick KM, Bender SM, Greenlee JD. Cervical decompression and reconstruction without intraoperative neurophysiological monitoring. J Neurosurg Spine 2012; 16 (02) 107-113
• 18 Lehman RA, Potter BK, Kuklo TR. , et al. Probing for thoracic pedicle screw tract violation(s): is it valid?. J Spinal Disord Tech 2004; 17 (04) 277-283
• 19 Ney JP, van der Goes DN, Nuwer MR. Does intraoperative neurophysiologic monitoring matter in noncomplex spine surgeries?. Neurology 2015; 85 (24) 2151-2158
• 20 Husain AM. Comment: Neurophysiologic intraoperative monitoring in “low-risk” spine surgeries. Neurology 2015; 85 (24) 2157
• 21 James WS, Rughani AI, Dumont TM. A socioeconomic analysis of intraoperative neurophysiological monitoring during spine surgery: national use, regional variation, and patient outcomes. Neurosurg Focus 2014; 37 (05) E10
• 22 Legatt AD, Laarakker AS, Nakhla JP, Nasser R, Altschul DJ. Somatosensory evoked potential monitoring detection of carotid compression during ACDF surgery in a patient with a vascularly isolated hemisphere. J Neurosurg Spine 2016; 25 (05) 566-571
• 23 Kobayashi K, Imagama S, Ito Z. , et al. Transcranial motor evoked potential waveform changes in corrective fusion for adolescent idiopathic scoliosis. J Neurosurg Pediatr 2017; 19 (01) 108-115
• 24 Chung HY, Suk KS, Lee HM. , et al. Growing rod technique for the treatment of the traumatic spinopelvic dissociation: a technical trick. Spine J 2016; 16 (03) e209-e214
• 25 Turner JD, Eastlack RK, Mirzadeh Z, Nguyen S, Pawelek J, Mundis Jr GM. Fluctuations in Spinal Cord Perfusion During Adult Spinal Deformity Correction Identify Neurologic Changes: Proof of Concept. World Neurosurg 2016; 85: 365.e1-365.e6
• 26 Allison DW, Gertsch JH, Mahan MA, Sheean GL, Brown JM. Anesthesia considerations for monitoring TCMEPs in adults diagnosed with poliomyelitis as children: a case report. Neurodiagn J 2014; 54 (01) 28-35
• 27 Sloan TB, Vasquez J, Burger E. Methohexital in total intravenous anesthesia during intraoperative neurophysiological monitoring. J Clin Monit Comput 2013; 27 (06) 697-702
• 28 Nakamae T, Tanaka N, Nakanishi K. , et al. Surgical treatment of high-grade dysplastic spondylolisthesis using intraoperative electrophysiological monitoring: report of two cases and review of the literature. Eur J Orthop Surg Traumatol 2013; 23 (Suppl. 01) S121-S127
• 29 Eck JC, Martin CJ, Lapinsky A, Connolly PJ, Dipaola C. Does intraoperative neurophysiological monitoring have predictive value for functional recovery following spinal cord injury? A case report. J Clin Monit Comput 2013; 27 (01) 93-96
• 30 Nair MN, Ramakrishna R, Slimp J, Kinney G, Chesnut RM. Left iliac artery injury during anterior lumbar spine surgery diagnosed by intraoperative neurophysiological monitoring. Eur Spine J 2010; 19 (Suppl. 02) S203-S205
• 31 Thirumala PD, Cheng HL, Loke YK, Kojo Hamilton D, Balzer J, Crammond DJ. Diagnostic accuracy of somatosensory evoked potential monitoring during scoliosis fusion. J Clin Neurosci 2016; 30: 8-14
• 32 Ghobrial GM, Williams Jr KA, Arnold P, Fehlings M, Harrop JS. Iatrogenic neurologic deficit after lumbar spine surgery: A review. Clin Neurol Neurosurg 2015; 139: 76-80
• 33 Block J, Silverstein JW, Ball HT. , et al. Motor evoked potentials for femoral nerve protection in transpsoas lateral access surgery of the spine. Neurodiagn J 2015; 55 (01) 36-45
• 34 Uribe JS, Vale FL, Dakwar E. Electromyographic monitoring and its anatomical implications in minimally invasive spine surgery. Spine 2010; 35 (26, Suppl) S368-S374
• 35 Martin DP, Bhalla T, Thung A. , et al. A preliminary study of volatile agents or total intravenous anesthesia for neurophysiological monitoring during posterior spinal fusion in adolescents with idiopathic scoliosis. Spine 2014; 39 (22) E1318-E1324
• 36 Gavassi BM, Oliveira CEAS, Barsotti CEG, Santos FPE, Pratali RR, Ferreira RJR. Positioning of pedicle screws in adolescent idiopathic scoliosis using electromyography. Coluna/Columna 2015; 14 (02) 100
• 37 Dominici M, Comerlato EA, Ventura FD, Chaloult E. Accuracy of two different criteria for neurophysiological intraoperative monitoring (NIOM) in spine/spinal cord surgeries. Arq Bras Neurocir 2014; 33 (01) 1-5
• 38 González VG, Burgos-Flores J, Del-Olmo T. , et al. Misplacement of lumbar pedicular screws that produce postoperative mechanical radiculalgia with normal intraoperative neurophysiological stimulation: the value of neurophysiological stimulation at the pedicular mid-track. Coluna/Columna 2013; 12 (04) 322-325
• 39 Habeych S, Miguel E. Intraoperative neurophysiological monitoring in pediatrics: Current controversies. . Salud UIS 2012; 44 (01) 7-16
• 40 García PC, Pérez MH, Lorensu PP, Rodríguez BD, Hernández PS, Rodrigo AA. Predictive value of electrical stimulation in cases of malposition of thoracic pedicle screws in spine surgery. Columna 2012; 11 (02) 169-170
• 41 Rodrigues LMR, Rosa FW, Ferreira RJ, Ueno F, Milani C. Herniated lumbar disc surgery in triathlon athletes with intraoperative neurophysiologic monitoring. Einstein (Sao Paulo) 2011; 9 (04) 530-533
• 42 Kai MR, Brooks JBB, Silva CAC, Rotta JM, Botelho R. The value of multimodal intraoperative monitoring during spinal surgery. Arq Bras Neurocir 2011; 30 (01) 3-6
• 43 Pasqualini W, Carvalho MOP, Kanno RM, Castellon AT, Tebet MA. Intraoperative neurophysiological monitoring of patients undergoing idiopathic scoliosis surgical correction. Coluna/Columna 2010; 9 (03) 282-286
• 44 Collado-Corona MA, de Leo-Vargas R, Sandoval-Sánchez V, Díaz-Hernández A, Gutiérrez-Sougarret BJ, Shkurovich-Bialik P. Neurophysiological monitoring in spinal cord surgery. Cir Cir 2009; 77 (05) 385-390
• 45 Agarwal N, Hamilton DK, Ozpinar A, Choi P, Hart R, Yaylali I. Intraoperative Neurophysiologic Monitoring for Adult Patients Undergoing Posterior Spinal Fusion. World Neurosurg 2017; 99: 267-274
• 46 Rumalla K, Yarbrough CK, Pugely AJ, Koester L, Dorward IG. Spinal fusion for pediatric neuromuscular scoliosis: national trends, complications, and in-hospital outcomes. J Neurosurg Spine 2016; 25 (04) 500-508
• 47 Thirumala PD, Bodily L, Tint D. , et al. Somatosensory-evoked potential monitoring during instrumented scoliosis corrective procedures: validity revisited. Spine J 2014; 14 (08) 1572-1580
• 48 Narita W, Takatori R, Arai Y. , et al. Prevention of neurological complications using a neural monitoring system with a finger electrode in the extreme lateral interbody fusion approach. J Neurosurg Spine 2016; 25 (04) 456-463
• 49 Grimm BD, Leas DP, Poletti SC, Johnson II DR. Postoperative Complications Within the First Year After Extreme Lateral Interbody Fusion: Experience of the First 108 Patients. Clin Spine Surg 2016; 29 (03) E151-E156
• 50 Cheng I, Acosta F, Chang K, Pham M. Point-Counterpoint: The Use of Neuromonitoring in Lateral Transpsoas Surgery. Spine 2016; 41 (Suppl. 08) S145-S151
• 51 Gavrancic B, Lolis A, Beric A. Train-of-four test in intraoperative neurophysiologic monitoring: differences between hand and foot train-of-four. J Clin Neurophysiol 2014; 31 (06) 575-579
• 52 Yaylali I, Ju H, Yoo J, Ching A, Hart R. Intraoperative neurophysiological monitoring in anterior lumbar interbody fusion surgery. J Clin Neurophysiol 2014; 31 (04) 352-355
• 53 Eager M, Shimer A, Jahangiri FR, Shen F, Arlet V. Intraoperative neurophysiological monitoring (IONM): lessons learned from 32 case events in 2069 spine cases. Am J Electroneurodiagn Technol 2011; 51 (04) 247-263
• 54 McClendon Jr J, O'Shaughnessy BA, Sugrue PA. , et al. Techniques for operative correction of proximal junctional kyphosis of the upper thoracic spine. Spine 2012; 37 (04) 292-303
• 55 Subramanian A, Wanta BT, Fogelson JL, Curry TB, Hannon JD. Time to extubation during propofol anesthesia for spine surgery with sufentanil compared with fentanyl: a retrospective cohort study. Spine 2014; 39 (21) 1758-1764
• 56 Şenköylü A, Zinnuroğlu M, Börçek A, Aktaş E, Güngör İ, Beyazova M. Comparison of multimodal intraoperative neurophysiological monitoring efficacy in early childhood and school aged children undergoing spinal surgery. Acta Orthop Traumatol Turc 2017; 51 (01) 49-53
• 57 Gavaret M, Pesenti S, Diop-Sene MS, Choufani E, Bollini G, Jouve JL. Intraoperative spinal cord monitoring: Lesional level diagnosis. Orthop Traumatol Surg Res 2017; 103 (01) 33-38
• 58 Chen Y, Wang BP, Yang J, Deng Y. Neurophysiological monitoring of lumbar spinal nerve roots: A case report of postoperative deficit and literature review. Int J Surg Case Rep 2017; 30: 218-221
• 59 Schär RT, Sutter M, Mannion AF. , et al. Outcome of L5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high-grade L5-S1 isthmic spondylolisthesis and the role of intraoperative neurophysiological monitoring. Eur Spine J 2017; 26 (03) 679-690