Real-time monitoring of the nervous system during surgery provides critical information to the surgeon allowing reversal or avoidance of neural insults. GGN carefully selects testing modalities (SSEP, MEP, EEG, EMG, ABR, VER) based on consultation with the surgeon, review of imaging, history, and other clinical data, and a brief physical examination of the patient prior to surgery. This risk assessment allows GGN’s surgical neurophysiologists to specifically tailor the monitoring approach to the patient’s clinical condition, the surgical procedure at hand and the surgeon’s preferences.
An extensive literature documents that deterioration of the patient’s signals during surgery suggests an impending surgical insult and is associated with an increased risk of postoperative deficit. Immediate intraoperative identification and notification to the surgeon of this risk allows corrective intervention to avoid postoperative impairment. GGN practitioners have a breath of experience in monitoring all of the surgical types from standard orthopedic spine to advanced complex procedures including but not limited to:
- Complex spine procedures – scoliosis, pedicle subtraction osteotomies, intramedullary tumors
- Selective dorsal rhizotomy, tethered cord, lumbosacral tumors
- Acoustic neuroma, cavernous sinus tumors, microvascular decompression, skull base meningioma
- Cerebral aneurysms – MCA, ACA, basilar tip, EC/IC bypass, arteriovenous malformations
- Cortical mapping – SEP polarity reversal, motor mapping, language mapping
- Thoracoabdominal aortic aneurysm, aortic arch replacement with hypothermia
- Interventional radiology procedures, brain and spinal cord
- Implantation of cerebral or spinal stimulating electrodes