Spine Surgeons Guntersville AL

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John C Alves, DDS
(256) 582-3398
1939 Patterson St Ste 101
Guntersville, AL
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Matthew Patrick Smith
(256) 571-8445
7938 Al Highway 69
Guntersville, AL
Specialty
Orthopedic Surgery

Data Provided By:
Baron Christopher Maze, MD
(205) 663-9102
1958 Autumn Creek Dr NE
Arab, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Al Sch Of Med, Birmingham Al 35294
Graduation Year: 2000

Data Provided By:
Joseph Charles Kendra, MD
(256) 571-8501
601A Corley Ave
Boaz, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Tn, Memphis, Coll Of Med, Memphis Tn 38163
Graduation Year: 1985

Data Provided By:
Raymond Lee Nichols Jr, MD
(256) 718-4041
426 W College St
Florence, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Tn, Memphis, Coll Of Med, Memphis Tn 38163
Graduation Year: 1987
Hospital
Hospital: Eliza Coffee Mem Hosp, Florence, Al; Helen Keller Hosp, Sheffield, Al; Shoals Hosp, Muscle Shoals, Al
Group Practice: Shoals Orthopedics

Data Provided By:
Donald C Martin Jr, MD
(256) 582-7251
Guntersville, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of South Al Coll Of Med, Mobile Al 36688
Graduation Year: 1983

Data Provided By:
Wayne H Garrett, DMD
(256) 878-7830
100 Andrew St Ste F
Albertville, AL
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Grant James Hyatt, MD
(248) 557-0704
PO Box 548
Grant, AL
Specialties
Orthopedics
Gender
Male
Education
Medical School: Wayne State Univ Sch Of Med, Detroit Mi 48201
Graduation Year: 1977

Data Provided By:
Kendra, Joseph MD
(256) 593-4363
601 Corley Ave Ste A
Boaz, AL

Data Provided By:
William Douglas Sudduth, MD
(205) 333-8800
PO Box 840
Northport, AL
Specialties
Orthopedics, General Practice
Gender
Male
Education
Medical School: Univ Of Al Sch Of Med, Birmingham Al 35294
Graduation Year: 1968

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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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