The intraoperative monitoring electrophysiology services we offer are displayed on the chart below. Refer to the chart to determine which structures are monitored with each modality, or to find the modalities used in a particular surgery.
| Modality |
Monitorable Structures |
Surgical Applications |
| Somatosensory Evoked Potentials |
Sciatic nerve
Lumbar and sacral nerve roots
Spinal cord
Brainstem somatosensory pathways
Monitoring metabolic function of cortical structures |
- Acetabular fractures
- Posterior lateral interbody fusion
- Lumbar fusion with instrumentation
- Cauda equine surgeries
- Spinal deformity surgery
- Spinal cord tumor surgeries
- Instrumented cervical surgery
- Skull base surgery requiring retraction of the brainstem
- Carotid endarterectomy
- Aneurysm surgeries
|
| Spinal Cord Evoked Potentials |
Spinal Cord |
- All surgeries that place the spinal cored at risk
|
| Transcranial Motor Evoked Potentials |
Spinal cord motor pathways |
- All spinal surgeries that place the motor pathways at risk
|
| Cortical Mapping |
Motor cortex and internal capsule,
Language areas of the brain,
Sensory cortex |
|
| Deep-Brain Single Unit Recordings |
Globus pallidus
Thalamus
Subthalamic nucleus
Optic pathways |
- Deep-brain stimulator electrode placement
- Pallidotomy
- Thalamotomy
|
| Auditory Evoked Potentials |
Cranial nerve VIII
Auditory brainstem pathways |
- Acoustic neuroma surgeries
- Vestibular nerve sections
- Microvascular decompression of VIIth or Vth cranial nerves
- Skull base surgeries when the brainstem risks retraction
- Posterior fossa surgeries
|
| Visual Evoked Potentials |
Optic nerve function anterior to the chiasm |
- Transphenoidal pituitary tumor surgery
|
| EEG and Computer Enhanced EEG |
Cortex |
- Carotid endarterectomy
- Cardiopulmonary bypass
- Evaluation of anesthetic effects
|
| Transcranial Doppler |
Middle cerebral artery
Aneurysm feeder arteries |
- Carotid endarterectomy
- Aneurysm surgeries
|
| Cerebral Venous Oxygen Saturation |
Cortical perfusion |
- Carotid endarterectomy
- Cardiopulmonary bypass
|
| Electromyography |
Cranial nerves:
Cranial nerves III, IV, V, VI, VII, IX, X, XI, and XII
Peripheral nerves:
All peripheral motor nerves
Spinal nerve roots |
Cranial nerves:
- Skull base surgeries whenever these cranial nerves are at risk
- Microvascular decompression of VIIth or Vth cranial nerves
- Acoustic neuroma surgeries
- Parotid surgeries
- Revision middle ear surgery
- Vestibular nerve sections
Peripheral nerves:
- Peripheral neuroma surgeries
- Monitoring of femoral nerve function during anterior acetabular surgery
Spinal nerve roots:
- Pedicle screw instrumentation surgeries
- Cauda equina surgeries
|
| Evoked Sensory and Motor Action Potentials |
Peripheral mixed nerves |
- Evaluating remaining nerve function in muscle flap grafts
- Peripheral neuroma surgery
|
To learn more about our electrophysiology services or how we may be able to help with your neurophysiologic intraoperative monitoring needs, contact Biotronic today.
