Spine Surgeons Temple Hills MD

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David C Johnson, MD
(202) 291-9266
106 Irving St NW
Washington, DC
Business
National Orthopedics PC
Specialties
Orthopedics

Data Provided By:
James E Callan MD
(301) 891-6130
7610 Carroll Ave
Takoma Park, MD
Specialties
Orthopedics

Data Provided By:
Jorge A Mondino, MD
(301) 567-2330
6357 Oxon Hill Rd
Oxon Hill, MD
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Nac De Cordoba, Fac De Cien Med, Cordoba, Argentina
Graduation Year: 1968

Data Provided By:
Jorge A Mondino
(301) 567-2330
6192 Oxon Hill Rd
Oxon Hill, MD
Specialty
Orthopedic Surgery

Data Provided By:
Henry Di Lorenzo, DDS
(301) 839-2500
6130 Oxon Hill Rd Ste 304
Oxon Hill, MD
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Edward G Alexander Jr., MD
(703) 461-7100
4801 Kenmore Ave
Alexandria, VA
Business
Northern Virginia Orthopaedic Group
Specialties
Orthopedics

Data Provided By:
Kenneth Hrechka, DDS
(301) 839-2500
6130 Oxon Hill Rd Ste 304
Oxon Hill, MD
Specialties
Orthodontics/Dentofacial Orthopedics

Data Provided By:
Rida Naguib Azer, MD
(301) 839-1600
6144 Oxon Hill Rd
Oxon Hill, MD
Specialties
Orthopedics
Gender
Male
Languages
Arabic
Education
Medical School: Kasr El Aini Fac Med Cairo Univ, Cairo (915-02 After 1/1971)
Graduation Year: 1959
Hospital
Hospital: George Washington Univ Hosp, Washington, Dc
Group Practice: Metropolitan Wash Orthopedic

Data Provided By:
Eric Geoffrey Dawson
(301) 567-2850
6196 Oxon Hill Rd Ste 310
Oxon Hill, MD
Specialty
Orthopedic Surgery

Data Provided By:
Melissa Ann Yadao, MD
(703) 549-1652
6144 Oxon Hill Rd
Oxon Hill, MD
Specialties
Orthopedics
Gender
Female
Education
Medical School: Va Commonwealth Univ, Med Coll Of Va Sch Of Med, Richmond Va 23298
Graduation Year: 1997

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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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