Intraoperative Neurophysiological Monitoring (IONM) for the Most Common Spinal Disorder in Aging Americans
September 22, 2020
Cervical Spondylotic Myelopathy is the most common spinal disorder in Americans over the age of 55. This spinal cord compression occurs when changes in the spine, either from age-related wear and tear or an injury, begin to compress the spinal cord. Symptoms often occur at the site of the compressed area of the spinal cord, and as the disease progresses, pain may begin to start at the neck and travel down the spine as well. This was the case for a 49-year old patient with symptoms that included constant neck pain, bilateral shoulder, and arm pain, tingling all over the body that was worse in the left arm, and trouble with ambulation or the ability to walk.
IONM Prevents Potential Spinal Cord Damage in Patient
During the procedure of an anterior cervical fusion at C4-C7, Electromyography (EMG) sensors, which record muscle activity related to the corresponding nerves and nerve roots alerted abnormal EMG activity in the right forearm. The surgeon was immediately informed and made the decision based on this real-time data to remove the C6-C7 implant and decompress further on the right side. The cage removal and further decompression resolved the noted EMG activity and the cage was then replaced without further abnormal EMG activity.
“Without this discovery, made possible by Intraoperative Neurophysiological Monitoring or IONM, the patient could have suffered from spinal cord or nerve damage resulting in muscle weakness, numbness, severe pain, and even paralysis, among other life-altering complications,” said Dr. Faisal R. Jahangiri of AXIS Neuromonitoring in Richardson, Texas.
Thanks to IONM and the decision made by the surgeon based on the data, this patient suffered no neurological complications post-surgery.
What is Intraoperative Monitoring, and How Does it Work?
This groundbreaking technique monitors the functioning of the body’s neural network using electrical responses from electrodes placed on the patient’s body during a surgical procedure. This reduces the risk of complications that can cause neurological injuries, which may not have been evident until after the procedure without the help of IONM. A two-person team consisting of a Neurotechnologist and a Physician work together to monitor the patient in the operating room and remotely online to ensure the integrity of the nervous system during the procedure. This means the surgeons can focus all of their attention on the procedure at hand while our team handles the data and reporting as it refers to the neural pathways of the body.