Posterior Cervical Spine Surgery
Fig. 32.1 Posterior cervical instrumentation and fusion of C1 ring fracture In preparation for these surgical procedures, a thorough evaluation of the bony and ligamentous anatomy guides the surgical approach…
Signal Optimization in Intraoperative Neuromonitoring
Fig. 17.1 Proximal stimulation with length-dependent neuropathy . Proximal stimulation (popliteal fossa) elicited tibial nerve SSEPs, whereas distal stimulation (ankle) did not in a patient with known diabetes but no…
Surgery of the Aortic Arch
Temperature (°C) Cerebral metabolic rate (% of baseline) Safe duration of HCA (min) 37 100 5 30 56 (53–60) 9 (8–10) 25 37 (33–42) 14 (12–15) 20 24 (21–29) 21…
IOM Instrumentation Layout and Electrical Interference
Fig. 16.1 Simplified recording circuit showing tissue voltage source V tissue, two impedances representing electrodes Z electrode1 and Z electrode2, and the input impedance of the amplifier Z amp Definition…
Monitoring of Spinal Cord Functions
Fig. 6.1 Recording methods of spinal cord potentials (SCPs). A catheter electrode is inserted into the dorsal epidural space using the same technique as that for the continuous epidural block…
EEG Monitoring
Fig. 10.1 Micrograph of cortical neuropil stained for neurons . The cell bodies of pyramidal neurons project apical dendrites upward and parallel with adjacent pyramidal cells Fig. 10.2 Current flow…
Monitoring of Jugular Venous Oxygen Saturation
CBF Cerebral blood flow CMRO2 Cerebral metabolic rate of oxygen O2ER Oxygen extraction ratio = (O2 consumption/O2 delivery) = AVDO2 × CBF/CaO2 × CBF = AVDO2/CaO2 = SaO2 − SjvO2/SaO2…
Surgery in the Peripheral Nervous System
Fig. 38.1 Degrees of nerve injury that leave the nerve in continuity . The mildest injury is neurapraxic, which represents a loss of electrical function with little, if any, anatomic…
Monitoring Applications and Evaluating Changes
Fig. 20.1 (a–g) A basic algorithm for the anesthesiologist and other members of the monitoring team to use in evaluating the possible contributions to response deteriorations The anesthesiologist is in…
The Use of Reflex Responses for IOM
Fig. 8.1 Spinal cord central pattern generator (CPG) components. The point of control is the level of excitability of segmental interneurons, which is determined by the integrated activity of the…
