Spine Surgeons Yakima WA

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Stephen P Roesler
(509) 454-6330
111 S 11th Ave
Yakima, WA
Specialty
Orthopedic Surgery

Data Provided By:
Chester S McLaughlin, MD
(509) 966-9592
622 S 36th Ave
Yakima, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Hahnemann Univ Sch Of Med, Philadelphia Pa 19102
Graduation Year: 1960

Data Provided By:
Ray Lyon Foster, MD
(206) 935-5696
110 S 9th Ave
Yakima, WA
Specialties
Orthopedics, Physical Medicine And Rehabilitation
Gender
Male
Languages
Other
Education
Medical School: Univ Of Cape Town, Fac Of Med, Cape Town, So Africa
Graduation Year: 1959
Hospital
Hospital: Community Mem Hosp, Enumclaw, Wa; Providence Med Ctr, Seattle, Wa
Group Practice: New Start Healthcare

Data Provided By:
Todd Busse Orvald, MD
1515 W Yakima Ave
Yakima, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Jefferson Med Coll-Thos Jefferson Univ, Philadelphia Pa 19107
Graduation Year: 1971

Data Provided By:
John Warrell Adkison, MD
(509) 454-5588
111 S 11th Ave Ste 320
Yakima, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Univ Of Wa Sch Of Med, Seattle Wa 98195
Graduation Year: 1973

Data Provided By:
James Jay Haven, MD
1515 W Yakima Ave
Yakima, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Temple Univ Sch Of Med, Philadelphia Pa 19140
Graduation Year: 1964

Data Provided By:
S Daniel Seltzer
(509) 966-9592
622 S 36th Ave
Yakima, WA
Specialty
Orthopedic Surgery

Data Provided By:
John J Hwang, MD
(509) 248-7184
1515 W Yakima Ave
Yakima, WA
Specialties
Orthopedics
Gender
Male
Education
Medical School: Johns Hopkins Univ Sch Of Med, Baltimore Md 21205
Graduation Year: 1992

Data Provided By:
John W Adkison
(509) 454-8888
1211 N 16th Ave
Yakima, WA
Specialty
Hand Surgery

Data Provided By:
Gary D Bos
(509) 574-3300
1470 N 16th Avenue
Yakima, WA
Specialty
Orthopedic Surgery

Data Provided By:
Data Provided By:

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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