Spinal procedures are considered major surgery. Specialists like Dr. Lipani use the most conservative surgical techniques as often as possible, and the benefits of a spinal procedure typically outweigh the risks. Regardless, a spinal surgeon is interested in relieving patients’ pain with the lowest amount of risk possible. Where applicable, then, Dr. Lipani performs surgery with intraoperative monitoring (IOM).
What is Intraoperative Monitoring?
The spine is one of the control-centers of the body, integral to the nervous system. Intraoperative monitoring is performed to observe how the nerves are functioning throughout a surgical procedure. An IOM technologist uses advanced devices that have become the standard of care in recent years. The techniques applied during surgery evaluate the electrical activity or muscle response in multiple muscles utilizing nerve stimulation. As the surgeon works to correct the spinal problem, these devices collect vital information from the central nervous system to keep the surgical team informed of nerve function. The purpose of IOM is to minimize the chances of nerve damage.
Prior to the use of Intraoperative Monitoring, surgeons used physical methods of observing nerve function during complicated surgeries. One was to ask the patient to move certain parts of the body that would be affected by surgery. Obviously, this test could not be performed until the patient had woken up from general anesthesia. It’s limitation was that damage may not be discovered quickly enough to repair it. Another test that a surgeon would perform is called a clonus test. In this method, the doctor would stretch the patient’s ankle while they were still under general anesthesia. Neurological dysfunction would be identified by repeated, rhythmic contractions of the muscles around the ankle. Though this test could be performed earlier, there was still a risk of catching dysfunction too late for repair.
Intraoperative monitoring is a valuable tool for certain surgical procedures in which risks of nerve damage are higher. Intraoperative monitoring for Princeton Neurological Surgery is performed by United Intra-Operative Neuro-Monitoring (IONM), a practice that has demonstrated a consistently-high standard of excellence in surgical care. This partnership can help our patients feel more confident about the processes used during their surgery.
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