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New frontiers in intraoperative neurophysiologic monitoring: a narrative review
BACKGROUND AND OBJECTIVE: Neurological insults during surgery arise from anatomic and/or physiologic perturbations. Intraoperative neurophysiologic monitoring (IONM) fills a critical role of ensuring that any neurological insults during certain surgical procedures are caught in real-time to prevent...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632568/ https://www.ncbi.nlm.nih.gov/pubmed/37970609 http://dx.doi.org/10.21037/atm-22-4586 |
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author | Oliva, Anthony M. Montejano, Julio Simmons, Colby G. Vogel, Scott A. Isaza, Carlos F. Clavijo, Claudia F. |
author_facet | Oliva, Anthony M. Montejano, Julio Simmons, Colby G. Vogel, Scott A. Isaza, Carlos F. Clavijo, Claudia F. |
author_sort | Oliva, Anthony M. |
collection | PubMed |
description | BACKGROUND AND OBJECTIVE: Neurological insults during surgery arise from anatomic and/or physiologic perturbations. Intraoperative neurophysiologic monitoring (IONM) fills a critical role of ensuring that any neurological insults during certain surgical procedures are caught in real-time to prevent patient harm. IONM provides immediate feedback to the surgeon and anesthesiologist about the need for an intervention to prevent a neurologic deficit postoperatively. As important as it seems to have IONM available to any patient having surgery where a neurological injury is possible, the truth is that IONM is unavailable to large swaths of people around the world. This review is intended to bring attention to all of the ways IONM is critically important for a variety of surgeries and highlight the barriers preventing most patients around the world from benefiting from the technology. Expansion of IONM to benefit patients from all over the world is the new frontier. METHODS: We searched all English language original papers and reviews using Embase and MEDLINE/PubMed databases published from 1995 to 2022. Different combinations of the following search terms were used: intraoperative neuromonitoring, neurosurgery, low-income countries, cost, safety, and efficacy. KEY CONTENT AND FINDINGS: We describe common IONM modalities used during surgery as well as explore barriers to implementation of IONM in resource-limited regions. Additionally, we describe ongoing efforts to establish IONM capabilities in new locations around the world. CONCLUSIONS: In this paper, we performed a review of the literature on IONM with an emphasis on the basic understanding of clinical applications and the barriers for expansion into resource-limited settings. Finally, we provide our interpretation of “new frontiers” in IONM quite literally facilitating access to the tools and education so a hospital in Sub-Saharan Africa can incorporate IONM for their high-risk surgeries. |
format | Online Article Text |
id | pubmed-10632568 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-106325682023-11-15 New frontiers in intraoperative neurophysiologic monitoring: a narrative review Oliva, Anthony M. Montejano, Julio Simmons, Colby G. Vogel, Scott A. Isaza, Carlos F. Clavijo, Claudia F. Ann Transl Med Review Article | Data-Driven Clinical Practice and Policy Making BACKGROUND AND OBJECTIVE: Neurological insults during surgery arise from anatomic and/or physiologic perturbations. Intraoperative neurophysiologic monitoring (IONM) fills a critical role of ensuring that any neurological insults during certain surgical procedures are caught in real-time to prevent patient harm. IONM provides immediate feedback to the surgeon and anesthesiologist about the need for an intervention to prevent a neurologic deficit postoperatively. As important as it seems to have IONM available to any patient having surgery where a neurological injury is possible, the truth is that IONM is unavailable to large swaths of people around the world. This review is intended to bring attention to all of the ways IONM is critically important for a variety of surgeries and highlight the barriers preventing most patients around the world from benefiting from the technology. Expansion of IONM to benefit patients from all over the world is the new frontier. METHODS: We searched all English language original papers and reviews using Embase and MEDLINE/PubMed databases published from 1995 to 2022. Different combinations of the following search terms were used: intraoperative neuromonitoring, neurosurgery, low-income countries, cost, safety, and efficacy. KEY CONTENT AND FINDINGS: We describe common IONM modalities used during surgery as well as explore barriers to implementation of IONM in resource-limited regions. Additionally, we describe ongoing efforts to establish IONM capabilities in new locations around the world. CONCLUSIONS: In this paper, we performed a review of the literature on IONM with an emphasis on the basic understanding of clinical applications and the barriers for expansion into resource-limited settings. Finally, we provide our interpretation of “new frontiers” in IONM quite literally facilitating access to the tools and education so a hospital in Sub-Saharan Africa can incorporate IONM for their high-risk surgeries. AME Publishing Company 2023-07-26 2023-10-25 /pmc/articles/PMC10632568/ /pubmed/37970609 http://dx.doi.org/10.21037/atm-22-4586 Text en 2023 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Review Article | Data-Driven Clinical Practice and Policy Making Oliva, Anthony M. Montejano, Julio Simmons, Colby G. Vogel, Scott A. Isaza, Carlos F. Clavijo, Claudia F. New frontiers in intraoperative neurophysiologic monitoring: a narrative review |
title | New frontiers in intraoperative neurophysiologic monitoring: a narrative review |
title_full | New frontiers in intraoperative neurophysiologic monitoring: a narrative review |
title_fullStr | New frontiers in intraoperative neurophysiologic monitoring: a narrative review |
title_full_unstemmed | New frontiers in intraoperative neurophysiologic monitoring: a narrative review |
title_short | New frontiers in intraoperative neurophysiologic monitoring: a narrative review |
title_sort | new frontiers in intraoperative neurophysiologic monitoring: a narrative review |
topic | Review Article | Data-Driven Clinical Practice and Policy Making |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632568/ https://www.ncbi.nlm.nih.gov/pubmed/37970609 http://dx.doi.org/10.21037/atm-22-4586 |
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