Spine Surgeons Oak Ridge TN

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Duncan L Mc Kellar, MD
(865) 483-8478
988 Oak Ridge Tpke Ste 100
Oak Ridge, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: U Of Tx Med Sch At Houston, Houston Tx 77225
Graduation Year: 1983

Data Provided By:
Paul Ellsworth Spray, MD
(865) 483-9936
507 Delaware Ave
Oak Ridge, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: George Washington Univ Sch Of Med & Hlth Sci, Washington Dc 20037
Graduation Year: 1944

Data Provided By:
Michael Alan Mackay, MD
90 Vermont Ave Ste 300
Oak Ridge, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Wayne State Univ Sch Of Med, Detroit Mi 48201
Graduation Year: 1992

Data Provided By:
Randall Raymond Robbins, MD
90 Vermont Ave
Oak Ridge, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: La State Univ Sch Of Med In Shreveport, Shreveport La 71130
Graduation Year: 1989

Data Provided By:
Jean-Francois P Reat, MD
(865) 483-8478
988 Oak Ridge Tpke Ste 100
Oak Ridge, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Baylor Coll Of Med, Houston Tx 77030
Graduation Year: 1992
Hospital
Hospital: Fort Sanders Parkwest Med Ctr, Knoxville, Tn
Group Practice: Tennessee Orthopedic Clinic

Data Provided By:
Cletus J McMahon
(865) 482-9025
90 Vermont Ave
Oak Ridge, TN
Specialty
Orthopedic Surgery

Data Provided By:
Stephen Robert Arehart, DDS
(865) 482-3474
1950A Oak Ridge Tpke
Oak Ridge, TN
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Clifford Lewis Posman, MD
(865) 481-2541
90 Vermont Ave
Oak Ridge, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: Mi State Univ Coll Of Human Med, East Lansing Mi 48824
Graduation Year: 1980

Data Provided By:
Michael Patrick O'Brien, MD
90 Vermont Ave
Oak Ridge, TN
Specialties
Orthopedics
Gender
Male
Education
Medical School: St Louis Univ Sch Of Med, St Louis Mo 63104
Graduation Year: 1994

Data Provided By:
Michael Patrick O'Brien
(865) 482-9025
90 Vermont Ave
Oak Ridge, TN
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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