Neuromonitoring is used intraoperatively when the brain or the bone marrow need to be handled.
This method allows for a real-time monitoring of the nerve function intraoperatively, thus decreasing the likelihood of postoperative neurological complications to the maximum possible degree. Neuromonitoring is performed by specialized electrophysiologists.
Electrodes are placed on the patient’s skin and subcutaneously. The arrangement of the electrodes differs from patient to patient subject to the operation and the patient’s problem.Sensory and motor nerves and the path of pain are monitored with the assistance of electric stimulation, passing through the electrodes. This way, the speed and the strength of the nerve signals are measured.
At first, the patient’s basic nerve signals are documented and they are compared to the intraoperative signals. If a notable change is observed compared to the initial signals, the surgeon is notified in order to confirm the reasons behind this change before the damage becomes permanent.
More specifically, three different techniques are used for neuromonitoring. Motor Evoked Potentials (MEPs) are used for the control of the motor nerves deriving from the brain and ending up in various muscle groups of the body. Somatosensory Evoked Potentials (SSEPs) are used for the control of sensory nerves deriving from the skin and ending up in the brain. Finally, the Electromyography (EMG) is used for the monitoring of the signals produced within the muscles innervated around the spinal area that is being operated.