Abstract
The utility of IONM in the surgical treatment of peripheral nerve disorders is well established and described in the literature. The purpose of this presentation is to demonstrate the utility of IONM in brachial plexus surgery and review how the different clinical neurophysiologic testing modalities, such as nerve action potentials, EMG, SSEPs and TcMEPs can be used to assess different regions of this complex structure. Amongst other things, IONM can assist in identifying the different brachial plexus structures, determine areas of abnormality or injury, evaluate for peripheral nerve continuity and evaluate for possible root avulsion. However, in order to do this the IONM physician must have a clear understanding of the brachial plexus anatomy and of the specialized techniques used in assessing these structures. Thus, the following will be described in detail: 1. The technique used to obtain nerve action potentials; 2. Techniques used to determine peripheral and central continuity of neural structures; and 3. How IONM can alter surgical management. Unfortunately, the short time allocated for this presentation does not allow for a full discussion of this complex subject and the attendee is directed to reviews of the subject available in the literature.
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