The Basics Of Intra Operative Neurophysiological Monitoring For The Clinician

Intra-operative neuromonitoring (IONM) refers to a diverse and evolving collection of techniques used to provide real-time assurance of neurological integrity during surgery. Most frequently utilised during neurosurgical procedures, the use of IONM has increased dramatically over recent years, and there is an ongoing need for structured and accessible information in its principles, implementation and interpretation. This dynamic book provides a practical overview of IONM, in simple language and clearly illustrated. Uniquely, it is authored by experienced multidisciplinary clinicians affiliated to King’s College Hospital NHS Foundation Trust, a regional neurosciences centre in London, UK. Combining the expertise of anaesthetists, physiologists, surgeons and patients themselves, this guide represents an invaluable source of information for all staff and trainees involved in the pre-, intra- and postoperative care of patients undergoing IONM.

Intra-operative neuromonitoring (IONM) refers to a diverse and evolving collection of techniques used to provide real-time assurance of neurological integrity during surgery. Most frequently utilised during neurosurgical procedures, the use of IONM has increased dramatically over recent years, and there is an ongoing need for structured and accessible information in its principles, implementation and interpretation. This dynamic book provides a practical overview of IONM, in simple language and clearly illustrated. Uniquely, it is authored by experienced multidisciplinary clinicians affiliated to Kingâ (TM)s College Hospital NHS Foundation Trust, a regional neurosciences centre in London, UK. Combining the expertise of anaesthetists, physiologists, surgeons and patients themselves, this guide represents an invaluable source of information for all staff and trainees involved in the pre-, intra- and postoperative care of patients undergoing IONM.

Intraoperative Neurophysiologic Monitoring, Second Edition, contains chapters related to the monitoring of the spinal motor system and deep brain stimulation have been added. The anatomical and physiological basis for these techniques are described in detail as are the practical aspects of such monitoring. Chapters on monitoring of sensory systems and monitoring in skull base surgery have been re-written as has the chapter on monitoring of peripheral nerves.

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.

The third edition of this classic text again provides practical, comprehensive coverage of the anatomical and physiological basis for intraoperative neurophysiological monitoring. Written by a leading authority in the field, Dr. Aage Moller has updated this important title to again offer all the leading-edge knowledge needed to perform electrophysiological recordings in the operating room, to interpret the results, and to present the results to the surgeon. The field known as "intraoperative monitoring" has expanded rapidly to cover other uses of neurophysiology and electrophysiologic recordings during surgical operations that affect the brain, spinal cord, and other parts of the nervous system. These new areas are covered in this new edition. To better represent the content of the book and the field as it now stands, many of the chapters have been revised and new material has been added. While the general organization of the book is maintained, chapters such as monitoring of motor systems have been revised and extended with new material, including more detailed description of the anatomy and physiology of motor systems and new information about intraoperative monitoring.

Completely revised and updated second edition of the leading reference on intraoperative neurophysiology, this book covers IOM from the most basic theoretical and technical concepts to the most sophisticated procedures, placing them within the specific surgical context. Written by a multidisciplinary team of experts from Massachusetts General Hospital/Harvard Medical School, Intraoperative Neurophysiology provides a step-by-step approach to monitoring and mapping for a wide variety of complex surgical procedures by progressively building on prior learned material. Covering everything from set-up to troubleshooting and medical management, this book presents an integrated blueprint for choosing the right tests and customizing IOM procedures to the demands of each surgical challenge. Comprehensive in scope and filled with over 650 helpful illustrations, tables, and neurophysiologic recordings to aid interpretative understanding, this expanded edition includes practical examples of monitoring and mapping and details the importance of an individualized approach to IOM. A highly visual book, it continues to serve as a primary resource for physicians and technologists involved in monitoring to help reduce the operative risk of neurological damage in surgical patients. New to the Second Edition: Extensively broadened coverage of critical topics including mapping procedures brain mapping, and primary neurophysiologic testing in the operating room Six entirely new chapters on pediatric neuromonitoring, cerebral aneurysms, electrocorticography, deep brain stimulation, intradural extramedullary tumors, and cardiac procedures Enhanced decompressive and deformity correction surgery chapters with added description of surgical steps and mechanisms of injury Over 650 high-quality images to enrich and instruct readers Appendix with 100 Q&As with detailed rationales that tie back to the chapters

This book is a comprehensive, focused resource on intraoperative neurophysiological monitoring (IOM). This rapidly evolving field has created a demand for an up-to-date book such as this that builds on foundational concepts necessary to the practice of IOM in the context of anatomy and physiology. Each chapter is designed to not only inform the reader, but to also test the reader on the information presented - therefore promoting practical, problem-based learning. Surpassing the quality of its successful predecessor, Principles of Neurophysiological Assessment, Mapping, and Monitoring, Second Edition, is positioned to suit the needs of residents and fellows studying for the IOM certificate programs, physicians and anesthesiologists practicing IOM, and neurotechnologists both experienced and in training.

Intraoperative neurophysiological monitoring (IONM) has gained increasing interest during the past decades and is now an integral part of various surgical disciplines, especially in neurosurgery, but also in otolaryngology, orthopedics, vascular surgery and general surgery. With expanding applications and evolving techniques, the monitoring team is faced with increasingly complex tasks and responsibilities. Despite its importance and significance in modern surgical medicine and the expectations associated with it, IONM is still not a regular part of the training program of medical professionals. Although knowledge on monitoring is imparted in basic courses offered by a few professional societies, systematic training of medical and non-medical staff according to a standardized curriculum is still lacking.This book aims to contribute to closing this gap. It provides a practical guide to help medical, nursing, and technical personnel get familiar with intraoperative neuromonitoring. The basic tenor is to combine theoretical and practical knowledge and thus to systematically convey essential skills about fundamentals, possibilities, but also limitations of IONM to a broad circle of readers. In order to achieve this goal, the text has been reduced to the absolutely necessary length in favor of numerous illustrations and tables. After an introduction to the tasks, the significance, and the historical development of IONM, the anatomical, physiological and physical basics are presented. This is followed by a presentation of various modalities as well as stimulation and recording techniques. The intraoperative part begins with some information on the organizational processes in the operating room, the presentation of safety aspects, and a description of the influences of anesthesia on monitoring, including the special aspects of awake surgery. This is followed by some basic remarks on the interpretation of monitoring results and a rough overview of the application fields of IONM in various disciplines including representative case examples. The manual concludes with an evaluation of the efficiency of monitoring and practical recommendations for the detection and elimination of intraoperative sources of error. Self-tests in individual chapters are intended to give readers the opportunity to determine their level of knowledge.