Continuous mapping of the corticospinal tracts in intramedullary spinal cord tumor surgery using an electrified ultrasonic aspirator

Journal of Neurosurgery. Spine
Ori BarzilaiAkiva Korn

Abstract

Intramedullary spinal cord tumors (IMSCTs) represent a rare entity, accounting for 4%-10% of all central nervous system tumors. Microsurgical resection of IMSCTs is currently considered the primary treatment modality. Intraoperative neurophysiological monitoring (IONM) has been shown to aid in maximizing tumor resection and minimizing neurological morbidity, consequently improving patient outcome. The gold standard for IONM to date is multimodality monitoring, consisting of both somatosensory evoked potentials, as well as muscle-based transcranial electric motor evoked potentials (tcMEPs). Monitoring of tcMEPs is optimal when combining transcranial electrically stimulated muscle tcMEPs with D-wave monitoring. Despite continuous monitoring of these modalities, when classic monitoring techniques are used, there can be an inherent delay in time between actual structural or vascular-based injury to the corticospinal tracts (CSTs) and its revelation. Often, tcMEP stimulation is precluded by the surgeon's preference that the patient not twitch, especially at the most crucial times during resection. In addition, D-wave monitoring may require a few seconds of averaging until updating, and can be somewhat indiscriminate to laterality. T...Continue Reading

References

Jan 1, 1996·HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery·S S HannaC Leonhardt
Dec 1, 1995·The Journal of Small Animal Practice·N D Jeffery, S M Phillips
Dec 1, 1996·Journal of Neurosurgery·S ConstantiniF J Epstein
Oct 16, 2002·Stereotactic and Functional Neurosurgery·V Deletis, A Bueno De Camargo
Nov 21, 2002·The Annals of Thoracic Surgery·Charles C J DongMichael T Janusz
Jan 18, 2003·Journal of Neurology, Neurosurgery, and Psychiatry·S J JonesH A Crockard
Jul 20, 2007·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Michael E TobiasGeorge I Jallo
Jul 27, 2007·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Francesco SalaMassimo Gerosa
Feb 5, 2011·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Vedran Deletis, Francesco Sala
Feb 19, 2011·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·A SzelényiH Vatter
Nov 20, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Paolo CostaGiuliano Faccani
May 21, 2013·Journal of Neurosurgery. Spine·Jörg Klekamp
Sep 24, 2013·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·D B MacdonaldUNKNOWN American Society of Neurophysiological Monitoring
Jul 6, 2015·Current Treatment Options in Oncology·Rupa G JuthaniMichael A Vogelbaum

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Citations

Feb 14, 2018·Journal of Neurology, Neurosurgery, and Psychiatry·Vedran DeletisKarl F Kothbauer
Aug 20, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Jonathan RothShlomi Constantini
Oct 22, 2020·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Marco CenzatoEnrica Fava
Jan 7, 2021·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Yechiam SapirShimon Rochkind
Jul 17, 2021·Asian Journal of Neurosurgery·Leonardo Gilmone RuschelRicardo Ramina

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Software Mentioned

TcMEP
CUSA

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