Intraoperative neurophysiologic monitoring has shown a steady increase in use for surgeries in which neural structures may be at risk of injury. Some of the surgical techniques used carry inherent risks, and these risks have changed the way in which neurophysiologic monitoring has impacted patient safety and quality of care during surgical procedures. It is therefore crucial that those performing and interpreting intraoperative neurophysiologic monitoring are adequately trained. This book is a comprehensive guide to the current practice of intraoperative neurophysiology with chapters on various modalities and clinical uses. Separate chapters devoted to anesthesia, operating room environment, special considerations in pediatrics and the interpretation and reporting of neurophysiologic data are useful and complementary. Questions and detailed answers on the topics covered can be found on the accompanying website for study review. This book will be useful to the trainee as well as the neurophysiologist already in practice.
• Anesthetic agent tables are provided to allow comparison of agents and quick decision making • Questions and answers for study review are provided in the accompanying website • Written by physicians with over 75 years of combined clinical experience in the field
Preface; 1. Introduction, history, and staffing for intraoperative monitoring; 2. The preoperative assessment; 3. Magnetic stimulation; 4. The operating room environment and team approach: pitfalls and technical factors; 5. Basic pharmacology of anesthetic agents and their effects on neurophysiological monitoring; 6. Somatosensory evoked potential monitoring with scalp and cervical recording; 7. Transcranial electric motor stimulation: technique and exclusionary criteria; 8. Electrocorticography and intraoperative electroencephalography; 9. Brainstem auditory evoked potential monitoring; 10. Pedicle screw application and electromyographic recording; 11. Cranial nerve monitoring; 12. Peripheral nerve monitoring: basics and indications; 13. Special consideration in pediatric surgical monitoring; 14. Intraoperative neurophysiologic monitoring of vascular disorders; 15. Selective dorsal rhizotomies: technique and protocol for monitoring; 16. Interpreting and reporting the neurophysiological data to the surgical team: how to do it and when is it indicated?; 17. Intraoperative wake-up test; 18. Postoperative studies and outcomes: clinical indications and usefulness of a postoperative study; Index.