Intraoperative Spinal Monitoring
Intraoperative monitoring has been available for a number of years and recently has become almost a standard for spinal surgery. Highly trained spinal surgeons who have recognized its importance for patient safety are primary users. These surgeons either have recently completed their training and utilized this service, or have recognized the latest advanced techniques that can add to patient safety. Therefore they have adapted intraoperative monitoring to their surgical practice.
The purpose of intraoperative neurophysiologic monitoring is to notify the surgeon of potential injury to vital neural structures at a time when a clinical examination is not possible, while the patient is under anesthesia in the operating room. As such, it provides early warning to the surgeon who can then adapt or modify the operative procedure accordingly. With its use as a guide it helps the patient awaken with a satisfied result.
Prior to the arrival in the operating room, a technician will place electrodes on the patient's legs, arms, neck, and head. In addition, the technician asks the patient about his/her pertinent clinical history. Although the patient may be undergoing low back surgery, which may affect the legs, the arms are also monitored as pressure on a nerve can be picked up early. Repositioning can then improve the monitored neural pathway thereby avoiding a post-operative complication.
Many university medical centers across the United States, such as the Mayo Clinic and the University of Miami utilize this service. In our immediate area, many of the local hospitals utilize this very same service.
The service is provided by Neurometrics, Incorporated. The Medical Director, Morris Shlamowitz, MD, is a physician fully trained in neurology and anesthesiology. Dr. Shlamowitz completed his training at the University of South Florida in Tampa, Florida. In his final year, he served as Chief Resident.
Cathleen Zippay, R EEG/EP T, R ED T, CNIM is Neurometrics' Chief/Head Technologist. Ms. Zippay has trained at the Mayo Clinic and supervises the remaining technicians who are also certified in intraoperative monitoring. The combined staff has over 14 years of experience in operating room monitoring for the brain, spine, and peripheral nerves.
In conclusion, intraoperative neuromonitoring can add an additional level of safety for spinal surgery. If you are considering spinal surgery in the near future, request your surgeon to offer this service.