A Need During Knee Surgery
May 10, 2019
According to MLB.com reports, Detroit Tigers pitcher Matt Moore will soon undergo surgery on his injured right knee. The left-handed pitcher is expected to sit out for some time, but the team's managers hope he will be back on the mound in just four to six weeks, pending no complications.
There are a lot of risks to any surgical procedure. Reactions to anesthesia, risks of blood clots and the chance of infection are all very real possibilities. Another risk of surgery is damage to the neural structures of the body and the peripheral nerves, the portion of the nervous system that includes all the nerves in the body except the brain and the spinal cord.
The peripheral nerves help to transmit information from the body to the central nervous system. This information helps the body perform necessary and complex functions such as a movement of muscles and joints.
If the peripheral nerves become damaged from illness, disease or injury, motor function can become impaired. While injury can occur in many ways, nerves can become injured or damaged during surgical procedures, too.
"Surgery involves incisions, which means cutting through tissues and nerves to get to the treatment area," said Dr. Faisal Jahangiri, CNIM, D. ABNM, FASNM, of AXIS Neuromonitoring in Richardson, Texas.
Jahangiri, an expert neurophysiologist, says the risk to the peripheral nerves can be mitigated through intraoperative neuromonitoring during surgery.
Intraoperative neuromonitoring is an advanced surgical monitoring method that uses electrophysiological approaches, including electroencephalography and electromyography, a form of diagnostic testing, to evaluate and record the activity of the skeletal muscles.
During the surgical procedure, neuromonitoring technologists review data from electromyography and electroencephalography diagnostic devices and report any abnormalities to the surgeon.
"This allows the surgical team to know exactly what is happening to the patient during the procedure," Jahangiri said.
Neuromonitoring also helps to monitor the functional integrity of the nerves during surgical procedures.
"Neuromonitoring provides surgeons a real-time analysis of what is happening to a patient during the procedure and can signal if there is a potential risk to that patient that can cause further injury," said Jahangiri.
Intraoperative neuromonitoring is used in a wide range of surgical procedures, including cardiac and vascular surgery, neurological procedures, spinal surgeries, ENT procedures, and urological procedures.
Neuromonitoring is also useful in orthopedic procedures, such as joint-replacement surgeries and meniscus repair procedures like Moore and many other professional athletes undergo.
"Arthroscopic surgery to repair a meniscus tear is a commonly performed surgery, but that does not mean things cannot go awry in the operating room," Jahangiri said.
As many as one in 300 people undergo the procedure each year in the United States.
Moore, 29, tried to avoid the procedure through rehabilitation and rest but did not feel improvement after being on the bench.
Neuromonitoring is an emerging field slowly taking the lead in surgical monitoring because of its significant advantage over conventional inoperative wake-up testing procedures.
"Neuromonitoring allows physicians to get a better picture of events without the influence of anesthesia," Jahangiri said.
