Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion
Objective To review the evidence for the use of electromyography (EMG), motor-evoked potentials (MEPs), and somatosensory-evoked potentials (SSEPs) intraoperative neuromonitoring (IONM) strategies during lateral lumbar interbody fusion (LLIF), as well as discuss the limitations associated with each...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2021-09-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-2142440-220.pdf |
| _version_ | 1797333359901278208 |
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| author | Ram Alluri Jung Kee Mok Avani Vaishnav Tara Shelby Ahilan Sivaganesan Raymond Hah Sheeraz A. Qureshi |
| author_facet | Ram Alluri Jung Kee Mok Avani Vaishnav Tara Shelby Ahilan Sivaganesan Raymond Hah Sheeraz A. Qureshi |
| author_sort | Ram Alluri |
| collection | DOAJ |
| description | Objective To review the evidence for the use of electromyography (EMG), motor-evoked potentials (MEPs), and somatosensory-evoked potentials (SSEPs) intraoperative neuromonitoring (IONM) strategies during lateral lumbar interbody fusion (LLIF), as well as discuss the limitations associated with each technique. Methods A comprehensive review of the literature and compilation of findings relating to clinical studies investigating the efficacy of EMG, MEP, SSEP, or combined IONM strategies during LLIF. Results The evidence for the use of EMG is mixed with some studies demonstrating the efficacy of EMG in preventing postoperative neurologic injuries and other studies demonstrating a high rate of postoperative neurologic deficits with EMG monitoring. Multimodal IONM strategies utilizing MEPs or saphenous SSEPs to monitor the lumbar plexus may be promising strategies based on results from a limited number of studies. Conclusion The use of traditional EMG during LLIF remains without consensus. There is a growing body of evidence utilizing multimodal IONM with MEPs or saphenous SSEPs demonstrating a possible decrease in postoperative neurologic injuries after LLIF. Future prospective studies, with clear definitions of neurologic injury, that evaluate different multimodal IONM strategies are needed to better assess the efficacy of IONM during LLIF. |
| first_indexed | 2024-03-08T08:02:39Z |
| format | Article |
| id | doaj.art-7a111724cbf74578a6184f3a10619351 |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T08:02:39Z |
| publishDate | 2021-09-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-7a111724cbf74578a6184f3a106193512024-02-02T11:51:44ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912021-09-0118343043610.14245/ns.2142440.2201173Intraoperative Neuromonitoring During Lateral Lumbar Interbody FusionRam Alluri0Jung Kee Mok1Avani Vaishnav2Tara Shelby3Ahilan Sivaganesan4Raymond Hah5Sheeraz A. Qureshi6 Hospital for Special Surgery, New York, NY, USA Hospital for Special Surgery, New York, NY, USA Hospital for Special Surgery, New York, NY, USA Department of Orthopaedic Surgery, Keck Medical Center of University of Southern California, Los Angeles, CA, USA Hospital for Special Surgery, New York, NY, USA Department of Orthopaedic Surgery, Keck Medical Center of University of Southern California, Los Angeles, CA, USA Hospital for Special Surgery, New York, NY, USAObjective To review the evidence for the use of electromyography (EMG), motor-evoked potentials (MEPs), and somatosensory-evoked potentials (SSEPs) intraoperative neuromonitoring (IONM) strategies during lateral lumbar interbody fusion (LLIF), as well as discuss the limitations associated with each technique. Methods A comprehensive review of the literature and compilation of findings relating to clinical studies investigating the efficacy of EMG, MEP, SSEP, or combined IONM strategies during LLIF. Results The evidence for the use of EMG is mixed with some studies demonstrating the efficacy of EMG in preventing postoperative neurologic injuries and other studies demonstrating a high rate of postoperative neurologic deficits with EMG monitoring. Multimodal IONM strategies utilizing MEPs or saphenous SSEPs to monitor the lumbar plexus may be promising strategies based on results from a limited number of studies. Conclusion The use of traditional EMG during LLIF remains without consensus. There is a growing body of evidence utilizing multimodal IONM with MEPs or saphenous SSEPs demonstrating a possible decrease in postoperative neurologic injuries after LLIF. Future prospective studies, with clear definitions of neurologic injury, that evaluate different multimodal IONM strategies are needed to better assess the efficacy of IONM during LLIF.http://www.e-neurospine.org/upload/pdf/ns-2142440-220.pdflateral lumbar interbody fusionintraoperative neuromonitoringelectromyographysomatosensorymotor-evoked potentials |
| spellingShingle | Ram Alluri Jung Kee Mok Avani Vaishnav Tara Shelby Ahilan Sivaganesan Raymond Hah Sheeraz A. Qureshi Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion Neurospine lateral lumbar interbody fusion intraoperative neuromonitoring electromyography somatosensory motor-evoked potentials |
| title | Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion |
| title_full | Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion |
| title_fullStr | Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion |
| title_full_unstemmed | Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion |
| title_short | Intraoperative Neuromonitoring During Lateral Lumbar Interbody Fusion |
| title_sort | intraoperative neuromonitoring during lateral lumbar interbody fusion |
| topic | lateral lumbar interbody fusion intraoperative neuromonitoring electromyography somatosensory motor-evoked potentials |
| url | http://www.e-neurospine.org/upload/pdf/ns-2142440-220.pdf |
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