Resource Center

 

IOM may reduce clinical risk by alerting the surgical team allowing intervention and potential cost-savings.

Nuwer, M. R. et al. Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr. Clin. Neurophysiol. 1995; 96(1):6-11.

Wilson, L. et al. Cost-Effectiveness of Intraoperative Facial Nerve Monitoring in Middle Ear or Mastoid Surgery. Laryngoscope 2003; 113(10):1736-1745.

Wiedemayer, H. et al. The impact of neurophysiological intraoperative monitoring on surgical decisions: a critical analysis of 423 cases. J. Neurosurg. 2002; 96: 255-262.

Owen, J. Cost efficacy of intraoperative monitoring.  Seminars Spine Surg. 1997; 9(4):348-352.

Kombos, T. et al. Cost analysis of intraoperative neurophysiological monitoring (IOM).
Zentralbl. Neurochir. 2002; 63(4):141-145.

Austin, E.H. et al. Benefit of neurophysiologic monitoring for pediatric cardiac surgery. J. Thorac. Cardiovasc. Surg.1997;114:707-717.

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Neurological Procedures

Supra- infratentorial tumor resection

Grant, G.A. et al. Continuous somatosensensory evoked potential monitoring during brain tumor resection. J. Neurosurg. 2002; 97:709-713.

Yingling, C.D. et al. Identification of motor pathways during tumor surgery facilitated by multichannel electromyographic recording. J. Neurosurg. 1999; 91:922-927.

Duffau, H. et al. Usefulness of intraoperative electrical subcortical mapping during surgery for low-grade gliomas located within eloquent brain regions: functional results in a consecutive series of 103 patients. J. Neurosurg. 2003; 98:764-778.

Kombos, T. et al. Monitoring of intraoperative motor evoked potentials to increase the safety of surgery in and around the motor cortex. J. Neurosurg. 2001; 95:608-614.

Neuloh, G. et al. Motor evoked potential monitoring with supratentorial surgery. Neurosurg. 2004; 54(5):1061-1074.

Taylor, M.D. et al. Awake craniotomy with brain mapping as the routine surgical approach to treating patients with supratentorial intraaxial tumors: a prospective trial of 200 cases. J. Neurosurg. 1999; 90:35-41.

Romstock, j. et al. Continuous electromyography monitoring of motor cranial nerves during cerebellopontine angle surgery. J. Neurosurg. 2000; 93:586-593.

Dong, C.C.J. et al. Intraoperative facial motor evoked potential monitoring with transcranial electrical stimulation during skull base surgery. Clin. Neurophysiol. 2005; 116:588-596.

Soustial, J.F. et al. Monitoring of brain-stem trigeminal evoked potentials. Clinical applications in posterior fossa surgery. Electroencephal.Clin. Neurophys. 1993; 88:255-260.

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Vascular neurosurgery including vascular malformations and aneurysms

Quinones-Hinojosa, A. et al. Transcranial motor evoked potentials during basilar artery aneurysm surgery: technique application for 30 consecutive patients. Neurosurgery. 2004 Apr;54(4):916-24

Szelenyi, A. et al. Neurophysiological criteria for intraoperative prediction of pure motor hemiplegia during aneurysm surgery. Case report. J Neurosurg. 2003 Sep;99(3):575-8.

Lopez, J. et al. The use of electrophysiological monitoring in the intraoperative management of intracranial aneurysms. J. Neuro. Neurosurg. Psychiatry 1999; 66:189-196.

Sala, F. et al. Embolization of a spinal arteriovenous malformation: correlation between motor evoked potentials and angiographic findings: technical case report. Neurosurgery  1987; 45(4):932-937.

Dong, C.C.J. et al. Intraoperative spinal cord monitoring during descending thoracic and thoracoabdominbal aneurysm surgery. Ann. Thorac. Surg. 2002; 74:S1873-6

Guerit, J-M and Robert Dion. State-of-the-art of  neuromonitoring for prevention of immediate and delayed paraplegia in thoracic and thoracoabdominbal aortic surgery. Ann. Thorac. Surg. 2002; 74:S1867-9.

McDonald, D.B. and Michael Janusz. An approach to intraoperative neurophysiological monitoring of thoracoabdominal aneurysm surgery. J. Clin. Neurophys. 2002; 19(1):43-54.

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Temporal lobe resection

Ojemann, S.G. et al. Localization of language function in children: results of electrical stimulation mapping. J. Neurosurg. 2003; 98:465-470.

Ojemann, J. G. et al. Cortical stimulation mapping of language cortex by using a verb generation task: effects of learning and comparison to mapping based on object naming. J. Neurosurg. 2002; 97:33-38.

Wyler, A.R. et al. Subdural strip electrodes for localizing epileptogenic foci. J. Neurosurg. 1984; 60:1195-1200.

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Cranial nerve decompression for trigeminal neuralgia and hemifacial spasm

Sindou, M.P. Microvascular decompression for primary hemifacial spasm. Importance of intraoperative neurophysiological monitoring. Acta Neurochir (Wien). 2005 Oct;147(10):1019-26

Wilkinson, M.F. and A.M. Kaufmann. Monitoring of facial muscle motor evoked potentials during microvascular decompression for hemifacial spasm: evidence of changes in motor neuron excitability. J Neurosurg. 2005 Jul;103(1):64-9.

Murakami, H. et al. Monitoring of the lateral spread response in the endovascular treatment of a hemifacial spasm caused by an unruptured vertebral artery aneurysm. J. Neurosurg.  2004; 101:861-863.

Stechison, M.T. et al. Intraoperative mapping if the trigeminal nerve root: technique and application in the surgical management of pain. Neurosurgery. 1996 Jan; 38(1):76-82.

Stohr, M. et al. Somatosensory evoked potentials following trigeminal nerve stimulation in trigeminal neuralgia. Ann. Neurol. 1981; 9:63-66.

Kuchta, J. et al. Delayed hearing loss after microvascular decompression of the trigeminal nerve. Acta Neurchir. 1998; 140:94-97

Sundaram, P.K. et al. Trigeminal evoked potentials in patients with symptomatic trigeminal neuralgia due to intracranial mass lesions. Neuro. India 1999; 47:94-97.

Moller, A.R. and P.J. Jannetta. Monitoring auditory functions during cranial nerve decompression operations by direct recording from the eighth nerve. J. Neurosurg. 1983; 59:493-499.

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Deep Brain Stimulation

Starr, P.A. et al. Microelectrode-guided implantation of deep brain stimulators intom the globus pallidus internus for dystonia: techniques, electrode locations, and outcomes. Neurosurg. Focus 2004; 17(1):20-31.

Toda, H. et al. Deep brain stimulation in the treatment of dyskinesia and dystonia. Neurosurg. Focus 2004; 17(1):9-13.

Nikkhah, G. et al. Deep brain stimulation of the nucleus ventralia intermedius for Holmes (rubral) tremor and associated dystonia caused by upper brain stem lesions. J. Neurosurg. 2004; 100:1079-1083.

Guridi, J. et al. Targeting the basal ganglia for deep brain stimulation in Parkinson’s disease. Neurol. 2000; 55(Suppl 6): S21-S28.

Rodriguez-Oroz, M.C. et al. Bilateral deep brain stimulation of the subthalamic nucleus in Parkinson’s disease. Neurol. 2000; 55(Suppl 6): S45-S51.

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Peripheral nerve integrity

Bose, B. et al. Neurophysiologic monitoring of spinal nerve root function during instrumented posterior lumbar spine surgery. Spine 2002; 27(11):1444-1450.

Krassioukov, A.V. et al. Multimodality intraoperative monitoring during complex lumbosacral procedures: indications, techniques and long-term follow-up review of 61 consecutive cases. J. Neurosurg. (Spine) 2004; 3:243-253.

Owen J.H. et al.  The use of mechanically elicited electromyograms to protect nerve roots during surgery for spinal degeneration. Spine 1994; 19:1704-1710.

Haghighi, S.S. and R. Zhang. Activation of the external anal and urethral sphincter muscles by repetitive transcranial cortical stimulation during spine surgery. J. Clin. Monitoring Comp. 2004; 18(1):1-5.

Inoue, S. et al. Intraoperative monitoring of myogenic motor-evoked potentials from the external anal spincter muscle to transcranial electrical stimulation. Spine 2002; 27(11):E454-E459.

Williams, H.B. and J.K. Terzis. Single fascicular recordings: An intraoperative diagnostic tool for the management of peripheral nerve injuries. Plastic Reconstr. Surg. 1976; 57:562-569.

Holland, N.R. et al. Higher electrical stimulus intensities are required to activate chronically compressed nerve roots. Implications for intraoperative electromyographic pedicle screw testing. Spine 1998; 23(2):224-227.

Deletis, V. et al. Electrodiagnosis in the management of brachial plexus surgery. In: Hand Clinics:Brachial plexus surgery (J.A. Grossman,ed.). 1995; 11(4)555-561.

Fan, D. et al. Intraoperative neurophysiologic detection of iatrogenic C5 nerve root injury during laminectomy for cervical compression myelopathy. Spine 2002; 27(22):2499-2502.

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Tethered cord

Kothbauer, K.F. and Klaus Novak. Intraoperative monitoring for tethered cord surgery: an update. Neurosurg. Focus 2004; 16(2):1-5.

Kothbauer, K. et al. Intraoperative Motor and Sensory Monitoring of the Cauda Equina. Neurosurg. 1994; 34(4):702-707.

Shinomiya, K. et al. Intraoperative monitoring for tethered spinal cord syndrome. J. Spine 1991; 16:1290.

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Recurrent laryngeal nerve integrity

Pearlman, R.C. et al. Intraoperative monitoring of the recurrent laryngeal nerve using acoustic, free-run, and evoked electromyography. J. Clin. Neurophys. 2005; 22(2):148-152.

Mikuni, N. et al. Endotracheal tube electrodes to map and monitor activities of the vagus nerve intraoperatively. J. Neurosurg. 2004; 101:536-540.

Friedrich, T. et al. Intraoperative electrophysiological monitoring of the recurrent laryngeal nerve in thyroid surgery- a prospective study. Zentralbl. Chir. 2002; 127(5):414-420.

Thomusch, O. et al. Intraoperative neuromonitoring of surgery for benign goiter. Am. J. Surg. 2002; 183:673-678.

Marcus, B. et al. Recurrent laryngeal nerve monitoring in thyroid and parathyroid surgery:the University of Michigan experience. Laryngoscope 2003; 113(2):356-361.

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Spinal cord tumors

Moroto, N. et al. The role of motor evoked potentials during surgery for intramedullary spinal cord tumors. Neurosurg. 1997; 41(6):1327.

Szekely, G. et al. Somatosensory and motor evoked potentials in patients with tumors in the spinal canal. Acto Neurochir. 1998; 140:533-539.

Kothbauer, K. et al. Motor evoked potential monitoring for intramedullary spinal cord tumor surgery: correlation of clinical and neurophysiological data in a series of 100 consecutive procedures. Neurosurg. Focus 1998; 4:1.

Kothbauer, K. et al. Intraoperative spinal cord monitoring for intramedullary surgery: an essential adjunct. Pediatr. Neurosurg. 1997; 26:247-254.

Kothbauer, K. et al. Motor evoked potential monitoring for spinal cord tumor surgery. 1998 J. Neurosurg. 88:403A.

Quinones-Hinojosa, A. et al. Spinal cord mapping as an adjunct for resection of intramedullary tumors: surgical technique with case illustrations. Neurosurg. 2002; 51(5):1199-1207.

Fromme, K. et al. Spinal cord monitoring during intraspinal extramedullary tumor operations. Neurosurg. Rev. 1990; 13:195-199.

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Arnold-Chiari malformation

Anderson, R.C.E. et al. Chiari I malformation: potential role for intraoperative electrophysiologic monitoring. J. Clin. Neurophys. 2003; 20(1):65-72.

Milhorat, T.H. and P.A. Bolognese. Tailored operative technique for Chiari type I malformation using intraoperative color Doppler ultrasonography. Neurosurg. 2003; 53(4):899-906.

Anderson, R.C.E. et al. Improvement in brainstem auditory evoked potentials after subcortical decompression in patients with Chiari I malformations. J. Neurosurg. 2003; 98:459-464.

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Phase reversal for identification of the central (Rolandic) sulcus

Romstock, J. et al. Localization of the sensorimotor cortex during surgery for brain tumors: feasibility and waveform patterns of somatosensory evoked potentials. J. Neurol. Neurosurg. Psych. 2002; 72:221-229.

Rowed, D.W. et al. Somatosensory evoked potential identification of sensorimotor cortex in removal of intracranial neoplasms. Can. J. Neuro. Sci. 1997; 24(2):116-120.

Cedzich, C. et al. Somatosensory evoked potential phase reversal and direct motor cortex stimulation during surgery in and around the central region. Neurosurg. 1996; 38(5):962-970.

Suzuki, A. and Y. Nobuyuki. Intraoperative localization of the central sulcus by cortical Somatosensory evoked potentials in brain tumor. J, Neurosurg. 1992; 76:867-870.

Grant, G.A. et al. Continuous Somatosensory evoked potential monitoring during brain tumor resection. J. Neurosurg. 2002; 97:709-713.

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Language mapping

Ojemann, S.G. et al. Localization of language function in children: results of electrical stimulation mapping. J. Neurosurg. 2003; 98:465-470.

Ojemann, J. G. et al. Cortical stimulation mapping of language cortex by using a verb generation task: effects of learning and comparison to mapping based on object naming. J. Neurosurg. 2002; 97:33-38.

Signorelli, F. et al. The value of cortical stimulation applied to the surgery of malignant gliomas in language areas. Neurol. Sci. 2001; 22:3-10.

Haglund, M.M. et al. Cortical localization of temporal lobe language sites in patients with gliomas. Neurosurg. 1994; 34(4):567-576.

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Laminectomy and disc resection

Kombos, T. et al. Impact of Somatosensory evoked potential monitoring on cervical surgery. J. Clin. Neurophys. 2003; 20(2):122-128.

Bose, B. et al. Neurophysiologic monitoring of spinal nerve root function during instrumented posterior lumbar spine surgery. Spine 2002; 27(11):1444-1450.

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Pedicle screw  insertion and instrumentation

Darden, B. et al. Evaluation of pedicle screw insertion monitored by intraoperative evoked electromyography. J. Spinal Disorders 1996; 9(1):8-16.

Toleikis, J.R. et al. The usefulness of electrical stimulation for assessing pedicle screw placement. J. Spinal Disorders 2001; 13(4):283-289.

Danesh-Clough, T. et al. The use of evoked EMG in detecting misplaced thoracolumbar pedicle screws. Spine 2001; 26(12):1313-1316.

Clements, D. Evoked and spontaneous electromyography to evaluate lumbosacral pedicle screw placement. Spine 21(5):600-604.

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Spinal deformity (Scoliosis)

McDonald, D. et al. Monitoring scoliosis surgery with combined multiple pulse transcranial electric motor and Somatosensory-evoked potentials from the lower and upper extremities. Spine 2003; 28(2):194-203.

Owen, J. The application of intraoperative monitoring during surgery for spinal deformity. Spine 1999; 24(24):2649-2682.

Gunnarsson, T. et al. Real-time continuous intraoperative electromyographic and somatosensory evoked potential recordings in spinal surgery: correlation of clinical and electrophysiologic findings in a prospective, consecutive series of 213 cases. Spine 2004; 29(6):677-684.

David, B. Monitoring scoliosis surgery with combined multiple pulse transcranial electric motor and cortical somatosensory-evoked potentials from the lower and upper extremities. Spine 2003; 28:194-203.

Pelosi, L. et al. Combined monitoring of motor and Somatosensory evoked potentials in orthopaedic spinal surgery. Clin. Neurophys. 2002; 113:1082-1091.

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Spinal trauma

Tsirikos, A.I. et al. Spinal cord monitoring using intraoperative evoked potentials for spinal trauma. J. Spinal Disord. Tech. 2004; 17(5):385-394.

Norcross-Nechay, K. et al. Intraoperative Somatosensory evoked potential findings in acute and chronic spinal canal compromise. Spine 1999; 24(10):1029-1033.

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Hip and knee surgery

Arrington, E.D. et al. Monitoring of somatosensory and motor evoked potentials during open reduction and internal fixation of pelvis and acetabular fractures. Orthopedics  2000; 23(10)

Calder, H. B. and J. Mast. Sciatic nerve monitoring in acetabular surgeries. Am. J. EEG Technol. 1995; 35:113-134.

Sutherland, C.J. et al. Use of spontaneous electromyography during revision and complex total hip replacement. J. Arthroplasty 1996; 11(2):206-209.

Polo, A. et al. Nerve conduction changes during lower limb lengthening. Somatosensory evoked potentials (SEPs) and F-wave results. Electromyogr. Clin. Neurophys. 1999; 39(3):139-144.

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Aneurysm and AVM embolization

Quinones-Hinojosa, A. et al. Transcranial motor evoked potentials during basilar artery aneurysm surgery: technique application for 30 consecutive patients. Neurosurgery. 2004 Apr;54(4):916-24

Szelenyi, A. et al. Neurophysiological criteria for intraoperative prediction of pure motor hemiplegia during aneurysm surgery. Case report. J Neurosurg. 2003 Sep;99(3):575-8.

Lopez, J. et al. The use of electrophysiological monitoring in the intraoperative management of intracranial aneurysms. J. Neuro. Neurosurg. Psychiatry 1999; 66:189-196.

Sala, F. et al. Embolization of a spinal arteriovenous malformation: correlation between motor evoked potentials and angiographic findings: technical case report. Neurosurgery  1987; 45(4):932-937.

Dong, C.C.J. et al. Intraoperative spinal cord monitoring during descending thoracic and thoracoabdominbal aneurysm surgery. Ann. Thorac. Surg. 2002; 74:S1873-6

Guerit, J-M and Robert Dion. State-of-the-art of  neuromonitoring for prevention of immediate and delayed paraplegia in thoracic and thoracoabdominbal aortic surgery. Ann. Thorac. Surg. 2002; 74:S1867-9.

McDonald, D.B. and Michael Janusz. An approach to intraoperative neurophysiological monitoring of thoracoabdominal aneurysm surgery. J. Clin. Neurophys. 2002; 19(1):43-54.

Beese, U. Detection of middle cerebral artery emboli during carotid endarterectomy using transcranial Doppler ultrasonography. Stroke 1998; 29:2032-2037.

Quinones-Hinojosa, A. et al. Transcranial motor evoked potentials during basilar artery aneurysm surgery: technique application for 30 consecutive patients. Neurosurgery. 2004 Apr;54(4):916-24

Szelenyi, A. et al. Neurophysiological criteria for intraoperative prediction of pure motor hemiplegia during aneurysm surgery. Case report. J Neurosurg. 2003 Sep;99(3):575-8.

Lopez, J. et al. The use of electrophysiological monitoring in the intraoperative management of intracranial aneurysms. J. Neuro. Neurosurg. Psychiatry 1999; 66:189-196.

Sala, F. et al. Embolization of a spinal arteriovenous malformation: correlation between motor evoked potentials and angiographic findings: technical case report. Neurosurgery  1987; 45(4):932-937.

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Carotid angioplasty

Raithel, D. Recurrent carotid disease: optimum technique for redo surgery. J. Endovasc. Surg. 1996; 3:69-75.

Facco, E. et al. EEG nonitoring of carotid endarterectomy with routine patch-graft angioplasty: an experience in a large series. Neurophysiol. Clin. 1992; 22(6):437-446.

Rosenkranz. M. et al. The amount of solid cerebral microemboli during carotid stenting does not relate to the frequency of silent ischemic lesions. Am. J. Neuroradiology 2006; 27:157-161.

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Carotid endarterectomy

Manninen, P.H. et al. Somatosensory evoked potential monitoring during carotid endarterectomy in patients with a stroke. Anes. Anal. 2001; 93:39-44.

Isley, M.R. et al. Multimodality neuromonitoring for carotid endarterectomy surgery: determination of critical cerebral ischemic thresholds. Am. J. End. Technol. 1998; 38:65-122.

Cho, H.C. et al. Cerebral  monitoring by means of oximetry and Somatosensory evoked potentials during carotid endarterectomy. J. Neurosurg. 1998; 89:533-538.

Guerit, J-M. et al. Somatosensory evoked potential monitoring in carotid surgery. I. Relationships between qualitative SEP alterations and intraoperative events. Electroenceph. Clin. Neurophys. 1997; 104:459-469.

Beese, U. Detection of middle cerebral artery emboli during carotid endarterectomy using transcranial Doppler ultrasonography. Stroke 1998; 29:2032-2037.

Rowed, D.W. et al. Comparison of monitoring techniques for intraoperative intraoperative cerebral ischemia. Can. J. Neurol. 2004; 31:347-356.

Lustgarten, J.H. et al. Carotid endarterectomy after noninvasive evaluation by duplex ultrasonography and magnetic resonance angiography. Neurosurg. 1994; 34(4):612-619.

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Otological procedures (vestibular schwannoma and other tumors of the CPA)

Matthies, C. and M. Samli. Management of vestibular schwannomas (acoustic neuromas): the value of neurophysiology for evaluation and prediction of auditory function in 240 cases. Neurosurg. 1997; 40(5):919-930.

Goldrunner, R.H. et al. Quantitative parameters of intraoperative electromyography predict facial nerve outcomes for vestibular schwannoma surgery. Neurosurg. 2000; 46(5):1140-1148.

Mullatti, N. et al. Intraoperative monitoring during surgery for acoustic neuroma: benefits of an extratympanic intrameatal  electrode. J. Neurol. Neurosurg. Psychiatry 1999; 66:591-599.

Ator, G.A. et al. Acoustic neuroma and other tumors of the cerebellopontine angle. In: The Ear: Comprehensive Otology, edited by R.F. Canalis and P.R. Lambert. Lipponcott Williams & Wilkins, Philadephia. 2000; 847-867.

Matthies, C. and M. Samli. Management of vestibular schwannomas (acoustic neuromas): the value of neurophysiology for intraoperative monitoring of auditory function in 200 cases. Neurosurg. 1997; 40(3):459-468.

Anderson, D.E. et al. Resection of large vestibular schwannomas: facial nerve preservation on the context of surgical approach and patient-assessed outcome. J. Neurosurg. 2005; 102:643-549.

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Cardiac surgery

Alexander, J.C. Reduced postoperative length of stay may result from using cerebral oximetry monitoring to guide treatment. Outcomes Meeting 2002 Key West, FL

Braekken, S.K. et al. Association between intraoperative cerebral microembolic signals and postoperative neuropsychological deficit:   comparison between patients with cardiac valve replacement and patients with CABG. J. Neuro. Neurosurg. Psychiatry 2001; 65:573-576.

Edmonds, H. Cost of CABG surgery reduced by multimodlity neuromonitoring. Anes. Anal.1999; 88:1-2.

Edmonds, H.L. et al. The role of neuromonitoring in cardiovascular surgery. J. Cardiothorac. Vasc. Anesth. 1996; 10(1):15-23.

Rodriguez, R.A. et al.  Cerebral effects in superior vena caval cannula obstruction: the role of brain monitoring. Ann. Thorac. Surg. 1997; 64:1820-1822.

Stump, D. A. et al. Neurophysiologic monitoring and outcomes in cardiovascular surgery. J. Cardiothorac. Vasc. Anesth. 1999; 13(6):600-613.

Effect of intraoperative intervention on neurological outcome based on electroencephalographic monitoring during cardiopulmonary bypass. Ann. Thorac. Surg. 1989; 48:476-483.

Edmonds, H.L. Advances in neuromonitoring for cardiothoracic and vascular surgery. J. Cardiothorac. Vasc. Anesth. 2001; 15(2):241-250.

Stecker, M. M. Evoked potentials during cardiac and major vascular operations. Seminars Cardiothorac. Vasc. Anesth. 2004; 8(2):101-111.

Doblar, D.D. Intraoperative transcranial ultrasonic monitoring for cardiac and vascular surgery. Seminars Cardiothorac. Vasc. Anesth. 2004; 8(2):127-145.

Murkin, J.M. Perioperative multimodality monitoring: an overview. Seminars Cardiothorac. Vasc. Anesth. 2004; 8(2):167-171.

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