Osorio Dyrymary¹* and Hernández, Ayleen²

¹IONM Technologist, c/30 De Mayo, Santo Domingo, Distrito Nacional, Dominican Republic
²Clinical Neurophysiologist, c/Las Acacias, Santo Domingo, Distrito Nacional, Dominican Republic

*Corresponding Author: Osorio Dyrymary, IONM Technologist, c/30 De Mayo, Santo Domingo, Distrito Nacional, Dominican Republic.

Received: August 21, 2024; Published: October 09, 2024

Abstract

In the Dominican Republic, the use of intraoperative neurophysiological monitoring in spine surgeries is becoming more frequent every day, such as: surgeries to correct deformities, tumors, and lumbosacral surgeries, however the daily use in cervical spine surgeries is a matter of debate. We performed 263 cases of spinal surgery in 2023 from which a sample of 50 cervical cases was extracted with the same monitoring protocol. In all cases, we used multimodal monitoring (free-run and triggered electromyography, somatosensory evoked potentials, motor evoked potentials and Train of four). The Somatosensory Evoked Potentials modality was the one that issued the most alerts due to the changes recorded in both latency and amplitude. The factors with which the changes were related were surgical manipulation during decompression, the use of halogenated gases above 1.5 MAC, the position of the neck and traction of the patient's upper limbs to perform the surgical approach. Despite the challenges we face daily performing this work, we must not forget that intraoperative monitoring is to prevent and reduce the probability of new deficit in the patient. We must advocate for standardized anesthetic protocols for patients undergoing spinal surgery, raise awareness among physicians to indicate intraoperative neurophysiological monitoring in all cases with a high risk of neurological structures injury. On our side, is our duty to remain in constant learning that gives us all the necessary tools to contribute in a timely and efficient manner to any neurophysiological alert during the cases we perform, thus managing to give a positive value to the role we have been developing within the operating rooms.

 Keywords: IONM; Cervical Spine; Changes; Warning Criteria; SSEPs

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Citation

Citation: Osorio Dyrymary., et al. “Challenges in Intraoperative Neurophysiological Monitoring During Cervical Surgeries: Analysis of Surgeries Performed in the Dominican Republic in 2023”.Acta Scientific Medical Sciences 8.11 (2024): 41-48.

Copyright

Copyright: © 2024 Osorio Dyrymary., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.