Interoperative neuromonitoring involves the continuous and real-time monitoring of important functions of the nervous system during neurosurgical procedures. In this context, the use of neuromonitoring for tumor removal also provides the surgeon with functional neurological information that can result in a more optimal removal of the tumor. The resulting outcome can have a very positive impact on the patient’s quality of life following such interventions.
In many international medical and healthcare systems, intraoperative neuromonitoring is considered to be the standard of care. The technique is frequently requested and used in most neurosurgical operations. Areas of application include cranial neuromonitoring during surgery on the base of the skull, SEP and MEP modalities during aneurysm surgery and interventions on the brain stem, as well as phase reversals and cortical mapping for central tumor surgery.
During a typical neuromonitoring procedure involving tumor removal, the surgeon receives continuous feedback from neurostimulation >> to the functional area being operated on. This enables the operational strategy to be aligned with real-time responses and findings – structures other than the tumor are also largely spared during surgery and the patient is exposed to a much lower risk of suffering from postoperative impairment following tumor removal.
Intraoperative neuromonitoring is useful in the following applications:
Intraoperative neuromonitoring has a wide range of applications. These include surgical intervention during epilepsy surgery, vagus nerve stimulation and deep brain stimulation. Cerebral aneurysms can be safely clipped with the availability of intraoperative neuromonitoring information. Interventions on the brain stem, including tumor removal, can be carried out much more safely and interventions in supratentorial areas, including during tumor removal where continuous monitoring of the motor pathways in the central brain allow for an informed and complication-free procedure. For procedures on tumors in the posterior fossa, intraoperative monitoring of cranial nerves can be localized and monitored, providing for improved outcomes.
Spine stabilization is also less risky for patients with the aid of neuromonitoring. Neuromonitoring enables the surgeon to benefit from continuous information detailing motor and sensory pathway integrity.
Treatment for a spinal tumor and deformities also benefit from neuromonitoring techniques. The risk of impairment and permanent damage, which can lead to paralysis, is minimized. Plexus surgery and peripheral nerve surgery are now considered unimaginable without neuromonitoring. The use of intraoperative neuromonitoring in surgical treatments for tumor removal and other neurological interventions now helps toward lowering risk profiles.