Spine Surgeons Buckley WA

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Richard L Molen, DDS
Sumner, WA
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Donald Mott
(253) 697-5200
402 15th Ave Se
Puyallup, WA
Specialty
Orthopedic Surgery

Data Provided By:
Steven Charles Brack, DO
3801 5th St SE Ste 110
Puyallup, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Des Moines Univ, Coll Osteo Med & Surg, Des Moines Ia 50312
Graduation Year: 1981

Data Provided By:
Dr.Frederic Johnstone
(253) 845-9585
3801 5th St SE # 110
Puyallup, WA
Gender
M
Education
Medical School: Vanderbilt Univ Sch Of Med
Year of Graduation: 1982
Speciality
Orthopedic Surgeon
General Information
Accepting New Patients: Yes
RateMD Rating
5.0, out of 5 based on 1, reviews.

Data Provided By:
Steven K Yamamoto
(253) 845-9585
3801 5th St Se
Puyallup, WA
Specialty
Orthopedic Surgery

Data Provided By:
John Stewart Renn II, MD
10317 122nd St E
Puyallup, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Temple Univ Sch Of Med, Philadelphia Pa 19140
Graduation Year: 1964

Data Provided By:
James J Wyman
(253) 446-0750
11212 Sunrise Blvd E Ste 201
Puyallup, WA
Specialty
Orthopedic Surgery, Sports Medicine

Data Provided By:
Frederic Luke Johnstone, MD
3801 5th St SE Ste 110
Puyallup, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Vanderbilt Univ Sch Of Med, Nashville Tn 37232
Graduation Year: 1982

Data Provided By:
William Arthur Bulley Jr, MD
(253) 841-2929
324 E Pioneer
Puyallup, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduation Year: 1975

Data Provided By:
Wendall William Adams, MD
3801 5th St SE Ste 110
Puyallup, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Case Western Reserve Univ Sch Of Med, Cleveland Oh 44106
Graduation Year: 1979

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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