ACDF MEP & Recovery in Non-Myelopathic Patient
By Admin | May 01, 2023
Proper patient positioning is crucial for successful surgeries. Of course, sufficient exposure is necessary for a surgical team to access the area of the body in which they’re operating. This conventional wisdom is never more essential than during a spinal surgery. With the stakes during a spinal surgery being so high, the degree of access to vertebrae and nerve bundles can significantly interfere with the surgery’s outcome. In one instance, not enough exposure inhibits the surgeon’s ability to access the necessary structures, and in the other, too much exposure can neurologically compromise the patient.
For one 46 year old male patient, the potential consequences of undergoing the prescribed surgical intervention meant risking paralysis. The patient was living with severe arm and neck pain as a result of both a central and foraminal stenosis. In addition to the patient’s radiculopathy, he was also experiencing spondylosis. While the patient’s condition was non-myelopathic, progression of his condition risked a future development of herniated disks and bone spurs.
To ensure adequate access is available to perform such surgeries, surgeons often elect to place a roll, bump or gel under a patient’s shoulders to provide greater exposure of the area. This was the case in this patient’s multilevel ACDF with hardware removal and posterior laminectomy. During this procedure, intraoperative neuromonitoring, including somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) were integrated.
In establishing baseline readings for the patient prior to operating, the Axis neuromonitoring team reported a completely absent MEP reading. After significant troubleshooting, the team removed the shoulder roll that was placed earlier for greater exposure of the neck and saw motor evoked pACDF MEP & Recovery in Non-Myelopathic PatientACDF MEP & Recovery in Non-Myelopathic Patientotentials register in all muscle groups. This reading and adjustment alone likely saved the patient from significant paralysis had the surgery progressed with the roll in place.
"Intraoperative monitoring services can significantly reduce postoperative complications. For each surgery, we provide both an on-site neurophysiologist and an offsite telemonitoring physician so your surgeon can get instant feedback," said Kathryn Overzet Jaquez, VP of Clinical Development at Axis Neuromonitoring in Richardson, TX.
The patient’s procedure was then able to be performed as scheduled. Axis Neuro’s surgical neurophysiology team continued closely monitoring the patient's signals throughout the procedure and ensured a successful surgery with stable responses maintained throughout.
Pre-surgery conditions such as shoulder roll placement can have a significant impact on signal conduction. And as a result of intraoperative neuromonitoring, those conditions were able to be resolved prior to surgery and saved the patient from significant quality of life changes. Negative outcomes to this patient’s quality of life were not only averted by monitoring the appropriate signals,, but improvement was also achieved by undergoing the surgery he needed to relieve his symptoms.
Axis Neuromonitoring provides high-quality intraoperative neurophysiological monitoring (IONM). For more information about neuromonitoring and how our practices create the best patient outcomes, call 888-344-2947 or visit https://www.axisneuromonitoring.com.
