Intraoperative Neurophysiological Monitoring in Syringomyelia Surgery: A Multimodal Approach

J. Clin. Med., 2023 · DOI: 10.3390/jcm12165200 · Published: August 10, 2023

Simple Explanation

Syringomyelia is a condition where a fluid-filled cavity develops within the spinal cord, potentially leading to irreversible neurological damage. Surgery to drain this cavity carries a risk of damaging the spinal cord. Intraoperative neurophysiological monitoring (IONM) is used during surgery to monitor the spinal cord's function and help prevent injury. This involves both monitoring techniques like MEPs and SEPs and mapping techniques to identify neural structures. This study reviews ten syringomyelia surgeries using multimodal IONM, finding it feasible and reliable in preventing iatrogenic spinal cord injury by guiding the surgeon to a safe entry zone and detecting impending damage.

Study Duration

April 2016 and June 2021

Participants

Ten surgical procedures on nine patients with syringomyelia

Evidence Level

Not specified

Key Findings

1
Multimodal IONM, including MEPs, SEPs, EMG, and mapping techniques, is feasible and reliable in syringomyelia surgery.
2
IONM can help prevent iatrogenic spinal cord injury by guiding surgeons to safe myelotomy entry zones and detecting impending damage.
3
Intraoperative signal changes correlated well with postoperative neurological status, suggesting that IONM can help avoid permanent damage.

Research Summary

This retrospective study reviews ten syringomyelia surgeries using intraoperative neurophysiological monitoring (IONM) to prevent spinal cord damage. The study found that multimodal IONM, including MEPs, SEPs, EMG, and mapping techniques like dorsal column mapping, is feasible and reliable. IONM helps surgeons choose safe myelotomy entry zones and detects impending injuries, allowing for corrective maneuvers and preventing permanent spinal cord damage, as indicated by intraoperative signal changes correlating with postoperative neurological status.

Practical Implications

Surgical Guidance

IONM provides real-time feedback to surgeons, guiding them to safer surgical approaches and minimizing the risk of iatrogenic injury.

Improved Patient Outcomes

By detecting and preventing potential spinal cord damage, IONM can lead to better postoperative neurological outcomes for patients undergoing syringomyelia surgery.

Standard of Care

The findings support the adoption of multimodal IONM as a standard of care in syringomyelia surgery to enhance patient safety and surgical precision.

Intraoperative Neurophysiological Monitoring in Syringomyelia Surgery: A Multimodal Approach

Simple Explanation

Key Findings

Research Summary

Practical Implications

Surgical Guidance

Improved Patient Outcomes

Standard of Care

Study Limitations

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Was this summary helpful?

Intraoperative Neurophysiological Monitoring in Syringomyelia Surgery: A Multimodal Approach

Simple Explanation

Key Findings

Research Summary

Practical Implications

Surgical Guidance

Improved Patient Outcomes

Standard of Care

Study Limitations

Your Feedback

Was this summary helpful?