A Practical Approach to Neurophysiologic Intraoperative Monitoring, 2nd Edition

In the last decade, several professional societies have published guidelines on various aspects of monitoring, and other publications have further documented the utility of neurophysiologic intraoperative monitoring (NIOM). This book covers basic aspects of monitoring, provides details of monitoring specific types of surgeries, along with technical requirements and addresses the administrative aspects of running an NIOM service. The book is divided into three parts. Part I introduces the reader to the operating room environment and discusses all the basic NIOM modalities such as somatosensory, motor and brainstem auditory evoked potentials, electroencephalography (EEG) and electromyography (EMG), with each modality being discussed in a separate chapter. A chapter detailing anesthetic effects on NIOM is also in this part. The second part on clinical methods, reviews the use of NIOM in various types of surgeries including that of vertebral column, spinal cord, tethered cord, peripheral nerve and brainstem. The chapters present the basics of anatomy, physiology and surgery of the various procedures. Details of the monitoring modalities and their interpretative criteria are presented. Technical sections in each chapter review practical information about the logistics of monitoring a particular type of surgery. Part III, focusing on administrative issues, provides a lot of useful practical information, such as technical aspects of NIOM machines and remote monitoring. Other chapters discuss billing, ethical and legal issues. A separate chapter is dedicated to the requirement for training interpreting physicians and technologists.