Spine Surgeons Henderson NV
Las Vegas, NV
Desert Orthopaedic Center
Medical School: Creighton Univ Sch Of Med
Year of Graduation: 1990
Accepting New Patients: Yes
4.0, out of 5 based on 4, reviews.
Las Vegas, NV
Bone & Joint Specialists
Orthopedics, Degenerative Spinal Conditions
Cervical, Thoracic, and Lumbar Fusion
Cervical, Thoracic, and Lumbar Diskectomy
Cervical, Thoracic, and Lumbar Decompression
Total Disk Replacement - Cervical & Lumbar
Endoscopic Spinal Fusion
Medicare Accepted: Yes
Workmens Comp Accepted: Yes
Accepts Uninsured Patients: Yes
Emergency Care: Yes
Primary Hospital: Valley Medical Center
Residency Training: Stanford University Hosptial & Clinics
Medical School: University Of Arizona College of Medicine, 1997
Member Organizations: North American Spine Society
American Academy of Orthopaedic Surgeons
American Medical Association
State Medical Society
State Orthopaedic Society
Awards: American Board of Orthopaedic Surgeons - Board Certified
Languages Spoken: English,Spanish,Chinese
Medical School: Harvard Med Sch, Boston Ma 02115
Graduation Year: 1993
Medical School: Univ Of Nv Sch Of Med, Reno Nv 89557
Graduation Year: 1983
Medical School: Univ Of The Witwatersrand, Med Sch, Johannesburg, So Africa
Graduation Year: 1959
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...