I thought this was a clever addition to traditional #ionm for TAAA surgery.
Using a non-limb modality (BCR, anal tcMEP, pudendal, and anal EP) the authors looked to better differentiate spine from limb ischemia.
A small sample size, but you can see the low rate of establishing BSL is improved when trying them all.
You get what you get, but better than nothing.
And talk about a great experience for newcomers to the field clinicians looking to learn different modalities.
Selective hypoglossal nerve stimulation seems to be a great option in patients with obstructive sleep apnea. Maybe #IONM can take it further?
What might not be totally obvious, unless you're looking at it, is the rate of patients with bilateral innervation from the hypoglossal nerve.
Somewhere around 40%-50%.
What, if any, difference might this make?
On the upside, maybe bilateral tongue movement and bilateral tongue base opening could result in better outcomes?
Your breathing hole ends up
Selective hypoglossal nerve stimulation seems to be a great option in patients with obstructive sleep apnea. Maybe #IONM can take it further?
What might not be totally obvious, unless you're looking at it, is the rate of patients with bilateral innervation from the hypoglossal nerve.
Somewhere around 40%-50%.
What, if any, difference might this make?
On the upside, maybe bilateral tongue movement and bilateral tongue base opening could result in better outcomes?
Your breathing hole ends up
I interviewed the #IONM students at UM last week and asked a tough question. I'll walk you through a similar one...
And let's do it using this paper to fill in the details, as you'll see how the pros used a similar thought process to formulate a novel hypothesis to test.
Potentially expanding the scope of neuromonitoring and better serving our patients.
Here's how the question went:
I give them a couple of options on surgery types they told me they are comfortable doing, then create a scen
#IONM used to help better understand safety guidelines for foot surgery using tourniquets... results below.
Tourniquets used to prevent bleeding can cause ischemic injury. Like most everything else, it's dose-dependent.
So how much pressure and for how long seem like reasonable questions. SSEP and MEPs were used to help determine some guidelines.
Here are the results:
"Group 1 (LOPβ+β50 mmHg) exhibited a 50% decrease in the femoral nerve MEP value at an average of 47 min, whereas group 2 (LO
Free CNIM prep course (8.5 hours of video review). The link is on my Linkedin profile page.
If you're looking to start your neuromonitoring career, we're opening up a larger training class soon. You'll start out training in the OR and virtual classes, then start working independently. DM me for details.
- US citizens only
- you'll need a path to sit for the CNIM (a bachelor's degree or R.EEG)
- please have a resume ready to send over
Looking to hire a CNIM in Tulsa, OK. DM me for more details. #CNIM #neuromonitoring #IONM
The # of sweeps recommended for most evoked potentials is excessive.
The majority of cases would work just fine at 50-100.
Your time of acquisition gets much better. And time to determine changes is a major factor in preventing deficit.
Some of the recommendations for collecting 500-1000 sweeps might have been best practice for older equipment, but not something we should blindly carry forward.
π‘π²ππΏπΌπΊπΌπ»πΆππΌπΏπΆπ»π΄ ππΌπ―: I'm looking to hire a #CNIM in Baltimore, MD. DM me for details.
I'm looking to hire an experienced neuromonitoring clinician in Orlando, FL. US citizens only. Feel free to direct message me for more details.
Anyone who has taken national boards that include neuroanatomy had "Internal Auditory Canal" on a flashcard. Here's how that prep comes into play with #IONM...
While the bulk of what we do is to monitor for preservation, a good amount is also dedicated to identification and selection.
It's common to do so when there is needed exposure in the area of a neural structure or some space-occupying lesion that distorts the anatomy.
We want to first approximate its location and then isolate it.
We m
The most common #ionm change in adult spinal correction surgery? Anesthesia? Positional? Legitimate guesses, but not it. Results below.
A new paper's results showed a different story.
Those are secondary issues of doing the surgery, but it was the actual maneuvers of the surgery that, by a large amount, were the cause of the most signal changes.
Sounds reasonable, but not always the collective experience when speaking to others in the field.
Or my own, which would have positioning and anesth
