Intraoperative electromyography.
Intraoperative electromyography (EMG) provides useful diagnostic and prognostic information during spine and peripheral nerve surgeries. The basic techniques include free-running EMG, stimulus-triggered EMG, and intraoperative nerve conduction studies. These techniques can be used to monitor nerve roots during spine surgeries, the facial nerve during cerebellopontine angle surgeries, and peripheral nerves during brachial plexus exploration and repair. However, there are a number of technical limitations that can cause false-positive or false-negative results, and these must be recognized and avoided when possible. The author reviews these basic electrophysiologic techniques, how they are applied to specific surgical situations, and their limitations.
Holland
Neil R
NR
nhollan@dnamail.com
D020209:Cranial Nerve Injuries; D003943:Diagnostic Techniques, Neurological; D004558:Electric Stimulation; D004568:Electrodiagnosis / Q000379:methods*; D004576:Electromyography / Q000145:classification / Q000379:methods*; D005071:Evoked Potentials / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D016343:Monitoring, Intraoperative; D009132:Muscles / Q000502:physiology / Q000503:physiopathology; D009431:Neural Conduction; D019148:Neuromuscular Blockade / Q000009:adverse effects; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000601:surgery; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013126:Spinal Nerve Roots / Q000502:physiology / Q000503:physiopathology; D013997:Time Factors