Lumbar/Sacral Posterior Spinal Fusion
PROCEDURE
Stabilization of posterior spine with pedicle screws, typically accompanied with a laminectomy and decompression.
ELECTRODES
Corkscrew Electrodes - 10: Fz, Cz, CP3, CP4, CS5, M1, M2, M3, M4, GND
Electrode Pairs - 22 (44); Thenar/Hypothenar, Iliopsoas, Rectus Femoris, Vastus Lateralis, Vastus Medialis, Tibialis Anterior, Gastrocnemius, Extensor Hallucis/Abductor Hallucis, Anal Sphincter, ULN x 2, PTN x 2, GND
MODALITIES
EMG - All muscle groups
tEMG - Cervical muscle groups
SEP - UlN, PTN, cortical and subcortical
MEP - Responses from all muscle groups listed
EEG - 2 Channels: Fpz - CP3, FPz - CP4
T04 - For anesthetic depth of muscle relaxant
NOTES:
SEPs for arm positioning for prevention of brachial plexus palsy, Anal Sphincter for those cases at the conus or any concern over bowel or bladder function. For cases at L1, Abdominal muscles may be added for rostral coverage and Tibialis Anterior/Gastrocnemius electrodes may be combined. For sacral cases, Tibialis Anterior/Gastrocnemius are separated and the addition of the Peroneus Longus may be considered as an addition for sensitiivity. SEPs below the CONUS will not necessarily reflect a status change due to multiple pathways for ascending input. A pre-rotation to prone baseline may be requested by the surgeon, balance anesthesia accordingly.
Stabilization of posterior spine with pedicle screws, typically accompanied with a laminectomy and decompression.
ELECTRODES
Corkscrew Electrodes - 10: Fz, Cz, CP3, CP4, CS5, M1, M2, M3, M4, GND
Electrode Pairs - 22 (44); Thenar/Hypothenar, Iliopsoas, Rectus Femoris, Vastus Lateralis, Vastus Medialis, Tibialis Anterior, Gastrocnemius, Extensor Hallucis/Abductor Hallucis, Anal Sphincter, ULN x 2, PTN x 2, GND
MODALITIES
EMG - All muscle groups
tEMG - Cervical muscle groups
SEP - UlN, PTN, cortical and subcortical
MEP - Responses from all muscle groups listed
EEG - 2 Channels: Fpz - CP3, FPz - CP4
T04 - For anesthetic depth of muscle relaxant
NOTES:
SEPs for arm positioning for prevention of brachial plexus palsy, Anal Sphincter for those cases at the conus or any concern over bowel or bladder function. For cases at L1, Abdominal muscles may be added for rostral coverage and Tibialis Anterior/Gastrocnemius electrodes may be combined. For sacral cases, Tibialis Anterior/Gastrocnemius are separated and the addition of the Peroneus Longus may be considered as an addition for sensitiivity. SEPs below the CONUS will not necessarily reflect a status change due to multiple pathways for ascending input. A pre-rotation to prone baseline may be requested by the surgeon, balance anesthesia accordingly.