Thoracic Posterior Spinal Fusion
PROCEDURE
Stabilization of posterior spine, concentrated to the thoracic region, 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 - 23 (46); Brachioradialis, Thenar/Hypothenar, Intercostals, Abdominals, Iliopsoas, Rectus Femoris, Vastus Lateralis, Tibialis Anterior/Gastrocnemius, Extensor Hallucis/Abductor Hallucis, ULN x 2, PTN x 2, GND
*4 2.5m electrodes or extensions will be necessary for upper extremity SEP/MEPs for brachial plexus monitoring with the patient's arm in "Superman" position
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, additional electrodes can be placed at Erb's point for accuracy of stimulus delivery for SEPs. A pre-rotation to prone baseline may be requested by the surgeon, balance anesthesia accordingly. Triggered stimulation of pedicle screws may have lower thresholds due to the decreased size of pedicles and fineness of thoracic nervous innervation.
Stabilization of posterior spine, concentrated to the thoracic region, 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 - 23 (46); Brachioradialis, Thenar/Hypothenar, Intercostals, Abdominals, Iliopsoas, Rectus Femoris, Vastus Lateralis, Tibialis Anterior/Gastrocnemius, Extensor Hallucis/Abductor Hallucis, ULN x 2, PTN x 2, GND
*4 2.5m electrodes or extensions will be necessary for upper extremity SEP/MEPs for brachial plexus monitoring with the patient's arm in "Superman" position
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, additional electrodes can be placed at Erb's point for accuracy of stimulus delivery for SEPs. A pre-rotation to prone baseline may be requested by the surgeon, balance anesthesia accordingly. Triggered stimulation of pedicle screws may have lower thresholds due to the decreased size of pedicles and fineness of thoracic nervous innervation.