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Intraoperative neurophysiological monitoring (IONM) or intraoperative neuromonitoring is the use of electrophysiological methods such as electroencephalography (EEG), electromyography (EMG), and evoked potentials to monitor the functional integrity of certain neural structures (e.g., nerves, spinal cord and parts of the brain) during surgery.
[1] [2] Spinal nerve injury does not cause neck, mid back pain or low back pain, and for this reason, evidence has not shown EMG or NCS to be helpful in diagnosing causes of axial lumbar pain, thoracic pain, or cervical spine pain. [3] [4] [5] [1]
In addition to spinal stenosis, other lower back conditions such as spondylosis, tumors, infections and herniated or ruptured discs can cause NC. These conditions contribute to the potential narrowing of the spinal cord, increasing pressure and inducing damage on the spinal nerve roots, thus, causing paing, tingling or weakness in the lower body.
Electromyoneurography can also be used to measure patient recovery from surgical procedures, such as nerve repair. A study conducted on patients with proximal radial nerve injuries used the procedure to indicate the degree of both pre- and postoperative nerve damage. [ 8 ]
Repetitive nerve stimulation is a variant of the nerve conduction study where electrical stimulation is delivered to a motor nerve repeatedly several times per second. By observing the change in the muscle electrical response (CMAP) after several stimulations, a physician can assess for the presence of a neuromuscular junction disease, and differentiate between presynaptic and postsynaptic ...
Recovery following spinal fusion is extremely variable, depending on individual surgeon's preference and the type of procedure performed. [20] The average length of hospital stay for spinal fusions is 3.7 days. [6] Some patients can go home the same day if they undergo a simple cervical spinal fusion at an outpatient surgery center. [21]
A large study of spinal stenosis from Finland found the prognostic factors for ability to work after surgery were ability to work before surgery, age under 50 years, and no prior back surgery. The very long-term outcome (mean follow-up time of 12.4 years) was excellent-to-good in 68% of patients (59% women and 73% men).
Sometimes surgery is an option, although the prognosis is still very poor of regaining function of the affected nerve. [2] The goal of surgery is to join healthy nerve to unhealthy nerve. The most common surgical techniques include external neurolysis , end-to-end repair, nerve grafting , and nerve transfer from somewhere else in the body.