ANALYSIS OF MODALITIES USED DURING SPINAL NEUROMONITORING PROCEDURES IN THE CONTEXT OF THEIR USEFULNESS
Spinal neuromonitoring is a procedure that aims to monitor nerve function during spinal surgery. It is an important diagnostic tool that allows the surgeon to assess the state of the nervous system on an ongoing basis and avoid potential nerve damage during the procedure. Spinal neuromonitoring uses various modalities that can be divided into several categories:
1. Electromyography (EMG): EMG measures muscle activity by recording electrical muscle activity through electrodes placed on the skin. In the context of spinal neuromonitoring, EMG can be used to monitor muscle activities that are controlled by nerves that are at risk of injury during surgery. EMG allows the surgeon to detect potential nerve damage or pressure on them during surgery.
2. Somatosensory Evoked Potentials (SEPs): SEPs are recorded to monitor sensory function and nerve conduction. Electrodes are placed on the skin and electrical impulses are sent to the appropriate nerves. Nerve responses are then recorded, which reflect the conduction state of nerve signals. SEP monitoring allows for the detection of possible damage to the sensory nerves during the procedure.
3. Motion Evoked Potentials (MEPs): MEPs are used to monitor motor function during spinal surgery. This involves stimulating the nerves responsible for muscle control and recording muscle responses. MEP assists the surgeon in assessing the integrity of the neural pathways responsible for movement. If a decrease or loss of MEP is identified, this may indicate damage to the motor nerves.
4. Electrocorticography (ECoG): ECoG is a technique that records the electrical activity of the brain using electrodes placed on the surface of the cerebral cortex. In the context of spinal neuromonitoring procedures, ECoG can be used to monitor brain activity and possible changes related to spinal manipulation.
All these modalities are useful in spinal neuromonitoring, as they allow the surgeon to assess the state of the nervous system during the procedure. They allow you to quickly detect possible nerve damage and take appropriate action, such as changing the operating strategy to minimize the risk of permanent nerve damage. Each modality has its own individual advantages and limitations, so they are often used simultaneously to ensure the greatest accuracy and completeness of nerve monitoring during spinal surgery. The research work is aimed at evaluating the usefulness of individual modalities used during intraoperative neuromonitoring in spinal surgery.