Spine Surgeons Festus MO

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Craig Richard Ruble, MD
(636) 933-7400
1360 Highway 61 JMH MOC No G1000
Festus, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Mo-Kansas City Sch Of Med, Kansas City Mo 64108
Graduation Year: 1996

Data Provided By:
Paul Ramon Maynard, MD
(636) 933-7400
1390 Highway 61 S Ste G1000 MOC-North
Festus, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Oh State Univ Coll Of Med, Columbus Oh 43210
Graduation Year: 1989

Data Provided By:
Theodore Koreckij, MD
(636) 937-4440
1400 US Highway 61
Festus, MO
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Ct Sch Of Med, Farmington Ct 06032
Graduation Year: 1976

Data Provided By:
Sidney Herbert Herr, DDS
(636) 296-6332
937 Jeffco Blvd
Arnold, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Robert A Shively, MD
(314) 652-4100
915 N Grand Ave
Saint Louis, MO
Business
Washington University Orthopedics
Specialties
Orthopedics

Data Provided By:
Paul Ramon Maynard
(636) 933-7400
1390 Highway 61
Festus, MO
Specialty
Orthopedic Surgery

Data Provided By:
Craig Richard Ruble
(636) 933-7400
1390 Highway 61
Festus, MO
Specialty
Orthopedic Surgery

Data Provided By:
James G Schaus, DDS
(636) 464-3020
4051 Jeffco Blvd
Arnold, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
George D Bankhead, DDS
(314) 843-5553
3890 S Lindbergh Blvd Ste 115
Saint Louis, MO
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Sherwyn Jordan Wayne
(314) 966-8887
1001 S Kirkwood Rd
Saint Louis, MO
Specialty
Orthopedic Surgery

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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