What is neuromonitoring?
The spinal cord is an extremely delicate and sensitive structure, and the slightest injury may have disastrous and irreversible consequences. Spinal surgery, therefore, is always fraught with the risk of increasing or producing neurological deficits. The latest and most sophisticated method of avoiding any insult to the neural tissue is the monitoring of the electrical activity of the spinal cord and nerves during operation so that the surgeon can be alerted before permanent damage to the neurological structures can occur.
How do we prepare you for the procedure?
Electrodes are fixed to the relevant areas of the body after the patient has been anaesthetised and positioned for surgery on the operation table. Wires connect these electrodes to the recording and monitoring device which is manned by a highly trained and experienced Neuro-physiology technician.
How does it help the surgeon and the patient?
The spinal cord works as a conduit between the brain and the rest of the body by transmitting signals to and from the brain. Damage to the spinal cord disrupts this function resulting in paralysis. Complex deformity correction surgeries around the spinal cord entail a 1% risk of potential injury to the spinal cord depending on the severity of the deformity and existing neurological compromise. This problem has been greatly reduced by the availability of spinal monitoring system. The surgeon thus gets information about impending cord or nerve damage before there is permanent loss of function leading to unpredicted and persistent neurological deficit. In our set-up Neuromonitoring is used widely as a routine procedure enabling our surgical teams to undertake difficult and complicated spine surgical procedures with a far lesser risk of post-operative morbidity.
Are you worried about risks of paralysis in spine surgery?
Spinal cord monitoring systems enable immediate identification of potential injury to the spinal cord during such surgeries even before any permanent damage to the spinal cord may occur. They can detect even small changes in the signals during the surgery so that serious injury to the spinal cord could be prevented. Studies have demonstrated that with the combined use of TCMEPs (transcranial motor evoked potentials), SSEPS (somatosensory evoked potentials) and EMG (electromyography) as practised by our surgical team, the sensitivity to detecting any permanent motor or sensory neurological damage as be as high as 99.6%.
You should not be worrying. With the continuous knowledge about the integrity of the spinal cord during the spine surgery, the spinal cord is never at-risk.
At SRF, an advanced system for intra operative continuous neural monitoring of the spinal cord function is available and used for deformity correction surgeries - this significantly improves the safety & accuracy of the surgery.
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What services we provide?
We provide technical services for neural monitoring during surgery at a hospital which does not have the facility of the same.
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Aims & Objectives
To make IONM as a standard of care in spine surgeries which might lead to spinal cord damage.
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Whom we cater to?
Any surgeon or hospital can avail this service and we cater to all those who require it.
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What exactly determines whether you will get the service or not in the first place?
It is decided by the respective operating team after evaluating with the safety concerns of the patient.
What does the equipment look like?
Neuromonitoring is an advanced computer-based monitoring system. Along with this machine a special type of anaesthesia is administered to obtain desired results which needs special equipments too.
Who are the members in our team/who all visits the OR?
Once you plan for a surgery under neural monitoring, you need three teams working synchronously. The surgical team, a team of anaesthesiologists specially trained to deliver anaesthesia for these types of patients, a team of intra operative neurophysiologists trained to evaluate the results obtained.