Intraoperative monitoring with free‐running EMG

Abstract

Publisher Summary This chapter discusses that intraoperative monitoring techniques are utilized with the goal of preserving function and preventing injury to vital neural structures at the time clinical examination is not possible. It discusses that the integrity of these central and peripheral neural structures can be effectively monitored with multimodal techniques during a wide variety of surgeries. The chapter reviews that multimodal intraoperative neurophysiologic monitoring has become a critical component to assure good outcomes in a variety of surgeries. The use of freerunning EMG is a relatively simple monitoring technique that is very useful to identify and protect the peripheral nerve structures at risk. It discusses that any procedure that requires manipulation or dissection of a nerve can be performed more safely and effectively with intraoperative EMG monitoring. The chapter reviews that understanding the technique of needle placement, the variety of recording electrodes, the pitfalls, and the interpretation of the findings is critical to providing rapid and accurate feedback to the surgeon. As with other intraoperative techniques, gaining experience in this modality is paramount to mastering the field of intraoperative neurophysiologic monitoring.