Medicine, 2022 · DOI: http://dx.doi.org/10.1097/MD.0000000000031846 · Published: December 2, 2022
This study compares the accuracy of a monitoring technique called transcranial motor-evoked potentials (TcE-MEPs) during two types of neck surgeries: anterior spinal fusion (ASF) and posterior spinal fusion (PSF). The goal was to see if the monitoring is equally reliable in both surgeries for preventing nerve damage. Researchers analyzed data from 415 patients who had either ASF or PSF for various neck problems. They looked at how often the monitoring system gave alarms, what actions were taken when alarms went off, and whether patients experienced any new nerve problems after surgery. The study found that the monitoring technique was generally useful in both types of surgeries. However, the specific surgical steps that triggered alarms were different between ASF and PSF. This suggests that surgeons need to be aware of these differences to effectively use the monitoring and prevent nerve damage during neck surgery.
Surgeons should be aware of the different surgical steps that are more likely to trigger neuromonitoring alarms in ASF versus PSF to proactively manage risks.
IONM should be considered a standard practice for both anterior and posterior cervical fusion surgeries to detect potential neurological damage during the procedure.
When TcE-MEP alarms occur, prompt decompression or fixation in adequate alignment may be necessary during posterior procedures to avoid neurological complications.