intraoperative neuromonitoring methods

The following is the current list of intraoperative neurophysiological techniques that Definitive NeuroDiagnostics is capable of performing at the moment. Surgeries may require one or more of these modalities, as each offers a unique approach to monitor your nerves in the operating room. Note that the list is subject to change as new technology and training becomes available. Contact Definitive NeuroDiagnostics if you have questions about any of the information.

intraoperative neuromonitoring-ssep-method

SSEP: Somatosensory Evoked Potentials

Somatosensory evoked potentials deal with the sense of touch. Stimulation pads are placed strategically on nerves that carry sensory fibers that lead to the region in the brain that picks up on touch sensation. Once the procedure begins, the intraoperative neuromonitoring technologist stimulates these nerves, which activates the pathway they take to the touch sensation receptors in the brain. Changes in SSEP’s reflect how well the messages are traveling in this pathway, and are recorded by the technologist and interpreted by the remote physician.


EMG: Electromyography

Electromyography shows us the messages sent from your muscles to the brain. For example, when you extend your arm, the triceps muscle will send an electrical message through your arm to your spinal cord and into the brain. When this pathway is altered, the EMG recordings will flare up, which the intraoperative monitoring technologist will document and remote physician will interpret. If deemed necessary, the technologist will communicate with the surgeon who will determine how to continue the procedure. The type of procedure determines which muscles the electrodes will be attached to, and corresponds to the nerve that may be at risk during the procedure.


TcMEP: Trans-Cranial Motor Evoked Potentials

Trans-Cranial Motor Evoked Potentials are signals that your brain sends to muscles in order to move them. For example, when you move your leg to walk, a message is sent from your brain through your spinal cord to your leg which tells it to move. This is a delicate modality, as it is sensitive to many implants and medical conditions that patients may have coming into the surgery. Because of this, your intraoperative neuromonitoring technologist will screen you before the procedure to identify any conditions that could affect TcMEP’s.


EEG: Electroencephalogram

Electroencephalogram simply shows the electric activity in the brain. In order to communicate with other parts of your body, the brain sends messages in the forms of electric impulses. EEG is used to monitor the course of these messages, as they are constantly being ‘fired’ in the brain. Changes to any portion of the brain or the corresponding body parts it controls can be recorded by the intraoperative neuromonitoring technologist using EEG.


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