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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]
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 ...
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 ]
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]
Needle EMG and NCSs are typically indicated when there is pain in the limbs, weakness from spinal nerve compression, or concern about some other neurologic injury or disorder. [10] 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 ...
[12] [14] However, before subjecting a patient to nerve conduction studies, both Tinel's test and Phalen's test should be performed. If both results are negative, it is very unlikely that the patient has CTS, and further testing is unnecessary. [13] Carpal tunnel syndrome presents in each individual to different extents.
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.