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Dad is in having spine surgery right now for several bad disks that have gotten tangled up around the spinal nerves. Before surgery, they told us the surgeon would be monitoring him to make sure things don't go bad. I guess he could end up paralyzed if something went wrong. I've been searching on-line about this business and found that not all surgeons do this because it's not really accurate. What can you tell me about this monitoring?
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Neuromonitoring techniques have been developed to help reduce the risk of permanent paralysis during spinal surgery. In a case like this with nerve tissue involved, it can be very complex and challenging to clean up the area without cutting into the nerve or in some cases, the spinal cord itself.
The use of neuromonitoring is an area of controversy in spinal surgery. This is a way of detecting whether or not the patient is in immediate risk of damage being done to the spinal cord or spinal nerve roots. The surgeon can either wake the patient up and test him or her for normal sensation and movement or use a special device that monitors the patient's neurologic status.
The wake-up test isn't very practical because it doesn't measure what's going on from moment-to-moment. In other words, you can't keep waking the patient up every minute to find out if everything is okay.
On the other hand, the use of tests such as electromyography, somatosensory evoked potentials (SSEP), and motor-evoked potentials (MEPs) can produce false negatives. A false negative means the test is negative indicating no problem when the patient is really compromised and in danger of paralysis. False negatives can be very serious.
According to a recent study, about 65 per cent of all spinal surgeons do make use of some form of neuromonitoring. The goal is to prevent (and reduce) the risk of new neurologic problems developing during spine surgery.
Some surgeons use more than one neuromonitoring technique in hopes of improving the chances of avoiding complications. Neuromonitoring for simple cases of disc removal isn't required. There are times when neuromonitoring is highly recommended such as when implants are being put in place to hold the vertebrae apart or to stabilize the spine.
It's likely that in your father's case, there was a real need for neuromonitoring. If you have further doubts, ask his surgeon for a more detailed explanation of the decision to use neuromonitoring.
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