Our service is all about bringing peace of mind to surgeons by providing a high level of patient safety.
Providing multimodal Intraoperative Neuromonitoring (IONM) for more than 20 years, has given our experienced Clinical Technologists at Nervesense insight and deep understanding of the surgeon’s needs.
Before the operation we will discuss all monitoring options with the surgeon and anaesthetist, considering all possible contraindications. This will help us to choose the optimal monitoring method.
We will set up the patients in the anaesthetic room, and we will establish the base line signal for both SSEP and MEP modes before surgery starts.
Free-running EMG will be monitored continuously, SSEP and MEP will be monitored on interval and related to the events.
It is advisable to verify that adequate stimuli are being delivered by observing a muscle contraction, (e.g., the small finger for the ulnar nerve; the big toe for the tibial nerve).
Deterioration of evoked response(s) (SSEP, DEP, MEP, AEP) can generally occur in the following procedures:
- Laminectomy
- Scoliosis / Spinal Deformity
- Discectomy
- Foraminotomy
- Distraction/Compression
- Graft impaction
- Tumour removal
- Vascular
- Implant placement
Spontaneous EMG generally occurs during:
- Electro-cautery
- Laminectomy
- Discectomy
- Foraminotomy
- Distraction/Compression/Rotation/Graft impaction
- Tumour removal
- Placement of sub-laminar hooks
- Pedicle screw fixation
- Lysis of adhesions
