This site requires javascript. Please turn that on in your browser\'s preferences. How?

Axis Neuromonitoring Axis Neuromonitoring

An Unassuming, but Common Bad Habit Can Lead to a Range of Back Problems.

By Admin | May 04, 2020

Published: May 4, 2020


Researchers estimate that around 50 million adults in the United States are living from chronic pain, and 20 million of that number suffer from pain so severe that it impacts their day-to-day living and even how they work. Many of these individuals are in chronic pain caused by problems with their back.

A vast majority of these individuals have injured their back at the workplace, but not from heavy lifting or exerting themselves in some extreme manner. They've hurt themselves from an activity that seems relatively benign and not very active at all: sitting.

Sitting for long periods can contribute to the development of a range of back problems—many individuals who sit all day in less-than-comfortable office chairs. In recent weeks, many individuals have also been forced to work on their less-than-ergonomic couch, bed, dining room table, or wherever as they work from home due to COVID-19. They are at risk of developing herniated discs, bulging discs, distorted muscles because of poor spinal alignment, spinal compression, and other painful back problems.

Sitting for long periods in an environment that is not ergonomic or comfortable for the back can put a tremendous amount of pressure on the bones and muscles of the back. This pressure can cause the bones of the spine to become pushed out of alignment.

When this happens, the bones and the discs that cushion these bones are pushed out of alignment against the nerves of the spinal column.

This can cause numbness, tingling, loss of mobility, and in some cases, partial or full paralysis.

A 30-year-old male patient experienced this when intervertebral disc displacement happened in the lumbar region of his spine.

The intervertebral disc of the back, also known as the intervertebral fibrocartilage, is found between the adjacent vertebrae in the spinal column. These discs act as a shock absorber for the spine and also allow the spine to move.

The patient, who's displacement was at L5-S1, presented with a history of low back pain, left and right leg pain, and right leg numbness. He underwent a discectomy to remove the discs between the vertebrae that were impacting the nerve and causing pain and numbness.

During his discectomy procedure, the patient was monitored using intraoperative neuromonitoring or IONM. IONM allows surgeons a better look as to what is happening in with a patient while on the operating table. It also helps to reduce the risk of complications for patients as a result of the procedure.

"Every surgery has the potential for risks. IONM helps to lower that risk by monitoring what is happening to the body's nerves, spinal cord, and how that impacts muscles, organs, and the functions of the body" said Dr. Faisal R. Jahangiri of AXIS Neuromonitoring in Richardson, Texas.

AXIS provides IONM services, staffing a technologist trained in neuromonitoring diagnostic tools in the operating room alongside surgeons.

"Their job is to watch the diagnostic machines for any changes in the patient signals and alert the surgeon of those changes," Jahangiri said.

This patient was monitored with diagnostics to check the ulnar nerve and posterior tibial nerve response through Somatosensory Evoked Potentials (SSEP), the function of the lower limbs with Electromyography (EMG) as well as Train of Four (TOF) and Electroencephalography (EEG) to check for depth of anesthesia.

During the surgical procedure, the AXIS IONM technologist noted a decrease in the patient's left lower Somatosensory Evoked Potentials (SSEP) response. Undetected, the change in the SSEP response could result in nerve damage to the patient's left leg that would not have been noticed until after surgery, including muscle weakness, numbness, tingling, pain, foot drop, and impacts the mobility.

The technologist also noted changes in the patient's EMG signals. Alerting the surgeon allowed adjustments to the nerve retraction and anesthesia to improve the patient's mean arterial pressure (MAP).

By making these changes, the patient's sensory signals in his left leg improved.

"Without IONM, this patient would have been left with a lesser quality of life," Jahangiri said.

« Return to ALL BLOG POSTS