Spine Surgeons Bellevue NE

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Wayne A Labart, DDS
(402) 292-4141
1411 J F Kennedy Dr
Bellevue, NE
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Jon Robert Shereck
(402) 294-6606
2501 Capehart Rd
Offutt A F B, NE
Specialty
Orthopedic Surgery

Data Provided By:
Charles Eugene Giangarra, MD
(402) 280-4342
3802 Raynor Pkwy
Bellevue, NE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Suny-Hlth Sci Ctr At Brooklyn, Coll Of Med, Brooklyn Ny 11203
Graduation Year: 1981

Data Provided By:
Dr.Brian Conroy
(402) 827-9400
1413 S Washington St # 200
Papillion, NE
Gender
M
Education
Medical School: Univ Of Ne Coll Of Med
Year of Graduation: 1995
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

Data Provided By:
Alfred Thomas Longo, DDS
(402) 496-9733
1826 N 144th St
Omaha, NE
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Brett Michael Andres, MD
(402) 294-6606
2501 Capehart Rd
Offutt A F B, NE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Johns Hopkins Univ Sch Of Med, Baltimore Md 21205
Graduation Year: 1998

Data Provided By:
Jon Robert Shereck, MD
(402) 294-6606
2501 Capehart Rd 55 MDOS/SGOSO
Offutt A F B, NE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Uniformed Services Univ Of The Hlth Sci, Bethesda Md 20814
Graduation Year: 1995

Data Provided By:
Joseph J Hurd, DDS
(402) 339-0506
8900 S 84th St
Papillion, NE
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Douglas Patrick Mc Innis, MD
(208) 667-7459
8536 Harrison St
La Vista, NE
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduation Year: 1997

Data Provided By:
Kathleen M Hubley, MD
(402) 559-2258
2826 S 34th St
Omaha, NE
Specialties
Orthopedics
Gender
Female
Education
Medical School: Creighton Univ Sch Of Med, Omaha Ne 68178
Graduation Year: 2001

Data Provided By:
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Monitoring Spinal Function During Spine Surgery

Any spine surgery is a very delicate operation. Care must be taken to prevent damage to the spinal cord, spinal nerves, and blood vessels supplying these neural components. Damage to the blood vessels and loss of blood supply to the spinal cord can have serious consequences.

Surgeons have an important tool available during spinal surgery to monitor patients called intraoperative neuromonitoring or IOM. IOM methods include the wake-up test, somatosensory-evoked potentials (SSEP), transcranial motor-evoked potentials (tcMEP), spinal cord MEPs, spontaneous electromyography (sEMG), and triggered electromyography (tEMG).

Each one of these tests has its own purposes and functions. But the basic idea behind this type of monitoring is to make sure moment-by-moment during the procedure that no injury has occurred. This is called real-time monitoring. Warning is given so that any damage can be prevented or reversed.

The tests must be accurate enough to avoid any false positives or false negatives. A false positive means the test says there's a problem when there really isn't one. A false negative is a test that doesn't indicate a problem when there is one.

In this study, neurosurgeons from the University of Pennsylvania and University of Virginia reviewed studies published on intraoperative neuromonitoring (IOM). They wanted to know how sensitive are each of the tests. Surgeons need to know what test values require immediate action.

Having these tests makes it possible to perform more complex spinal surgeries. That's important for patients with severe scoliosis undergoing spinal correction to get the best possible result. The same is true for cancer patients with spinal tumors that have to be removed. It allows the surgeon to be more aggressive when it's needed and with less risk of complications.

For each of the IOM tests, the authors provide a description of the test, when it would be used, and what the research reports about reliability, validity, and effectiveness of each test. Surgeons are given ways to avoid problems and obstacles with each test. A summary of all the technical information is provided with key points from the article offered in the conclusion.

Here's a sample of the type of information surgeons can obtain from this review. The wake-up test (gradually reducing the amount of anesthesia until the patient wakes up enough to move their arms and legs) has many more drawbacks than benefits compared to the other tests. It's easy to do but only offers a one-time look at what's going on when really ongoing monitoring is much better. It should only be used along with a more consistent test.

Somatosensory-evoked potentials (SSEPs) became popular in the late 1980s and early 1990s. They were thought to be reliable but it turned out there was a high rate of false negatives. SSEPs don't monitor all aspects of spinal cord, spinal nerve, and vascular (blood supply) function. They are not reliable to test mot...

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