Project details


Monitoring late responses during surgery. A systematic review.

Intraoperative neurophysiology IONM Spine surgery

Prof. dr. A.R. Absalom
Prof. dr. R.J.M. Groen
G. Drost
M.C. Gadella

Type of project:
Pilot project (year 2 or 3) of Stage Wetenschap / Researchproject

Nature of the research:
This is a literature study regarding the use and applicability of late motor responses during surgeries with a risk of spinal cord damage.

Fields of study:
anesthesiology neurosurgery neurology

Background / introduction
The University Medical Center Groningen is a pioneer in the Netherlands in the field of intraoperative neurophysiological monitoring (IONM) during orthopedic, neurosurgical and endovascular procedures. For many years, operations for scoliosis, intramedullary tumors, and tethered spinal cord syndromes have been performed using IONM. It is a complex activity that requires technical expertise, and the assessment is not always straightforward. It is known that in spinal surgery, IONM can predict the occurrence of damage well.
IONM is a method that is used during surgeries with a high risk of damage to the spinal cord. With help of IONM, the functional integrity of the neurological system can be checked during these high-risk procedures. Different modalities are used to monitor the functional integrity of these neurological structures. Most knowledge is available regarding transcranial electrical stimulation muscle motor evoked potentials (Tc-mMEPs) and somatosensory evoked potentials (SSEPs) modalities. However, late responses, (F-waves and H-reflexes) can be monitored during surgery as well.
Research question / problem definition
The goal of this research is to give an overview of the current knowledge regarding the use of intraoperative late response monitoring. Furthermore, recommendations regarding implementation of late responses in high-risk surgeries could follow based on the knowledge obtained.
During the research period, literature will be systematically searched with use of the PRISMA guidelines. The student will conduct a search in PubMed and abstract and full-text articles will be screened.
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