Types of IONM Continuous or signalled INITIATION UE: median or ulnar LE: post tib nerve or peroneal nerve RECORDING Transcranial somatosensory cortex Can use with NM blockade (not sensitive to anesthesia) Advantages Reliable, unaffected by anesthetics Disadvantages Nerve roots not checked Delay due to summation Tests Dorsal Columns Loss if: Impacts dorsal column Motor EvokedContinue reading “Neuromonitoring “
Author Archives: thespinebookadmin
Kyphoplasty Dr. Ahn
Indications Complications Preop Imaging Equipment Position Special Considerations Localize Marking Prep and Drape Approach Instrumentation Closure Post Op Care
Cortical Trajectory Screw (Finkelstein)
Shown to decrease incision size and blood loss for degen spondy
Subaxial PSD Dr. Ahn
Clinical Note: Dx: Cervical Myelopathy secondary to Spinal Stenosis at C56 Procedure: C56 Decompression only no fusion Preop: Cefazolin IV 1g Decadron 10mg IV Equipment: Ziehm fluoroscopy Jackson with bolsters Positioning: 1.) Jackson with bolsters 2.) Gentle log roll 3.) face on donut neutral flex-ex 4.)
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Indications Complications Preop Imaging Equipment Position Special Considerations Localize Marking Prep and Drape Approach Instrumentation Closure Post Op Care
Ahn Lumbar DC and Fusion
Consent forms were signed. Risks and benefits of surgery were discussed both with her and her son who is present. Certainly risks included, but are not limited to infection, especially with rheumatoid disease, misplaced screws or screws that pullout, especially considering her rheumatoid disease and potentially soft bone. Other risks certainly include dural tears, which isContinue reading “Ahn Lumbar DC and Fusion “
Ahn o-T1
The patient was brought into the Operating Room. Anesthesia had seen the patient. Preop Decadron was administered 10 mg IV for stress dosing. She received preoperative 2 g of IV Ancef along with Cipro for wound prophylaxis and UTI prophylaxis. She then got a general anesthetic with awake fiberoptic intubation. Once asleep, she was thenContinue reading “Ahn o-T1 “
Lumbar Microdisc Dr. Ahn
Indications Complications We discussed the risks, complications, benefits and alternatives of the intervention with him, which would be a right L4-L5 microdiskectomy. These include but are not limited to, injury to the nerve root, injury to the dural sac causing CSF leak requiring repair, infection, instability of the spine, stiffness, ongoing pain and discomfort, medical complications from theContinue reading “Lumbar Microdisc Dr. Ahn “
PCDF Dr. Ahn
Indications Myelopathy ACDF vs PCDF algorithm Complications Preop Imaging Equipment Jackson Table with Frame Stryker Navigation Machine C Arm Large Large Zelpis Stryker Oasys (https://www.stryker.com/us/en/spine/products/oasys.html) Headlight & Loupes (Approach) Microscope (Decompression) Position Surgical pause Move patient to Jackson Supine Intubate/ Arterial Line/ Foley Pneumatic TEDS on Pillows over shins Mayfields Loosen to maxContinue reading “PCDF Dr. Ahn “
ACDF Dr. Ahn
Complications Dysphagia Usually short term that resolves in 1 months up to 50% Dysphonia RLN – hoarseness 5-6% Pseudarthrosis Implant failure Neurologic injury Airway compromise ASD – 3% Preop Imaging CT Is there OPLL? Spurs? Calcified Disc? MRI Level of compression Nerve Roots Free? Vertebral Artery position -5% are aberrant (sometimes TF is within theContinue reading “ACDF Dr. Ahn “
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