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Daniel Haschtmann - One of the best experts on this subject based on the ideXlab platform.

  • the impact and value of uni and multimodal Intraoperative Neurophysiological Monitoring ionm on neurological complications during spine surgery a prospective study of 2728 patients
    European Spine Journal, 2019
    Co-Authors: Martin Sutter, Dezso Jeszenszky, Tamas F Fekete, Daniel Haschtmann, Andreas Eggspuehler, Frank S Kleinstueck, Francois Porchet, Jiri Dvorak
    Abstract:

    We compared the value of different uni- and multimodal Intraoperative Neurophysiological Monitoring (IONM) methods on the detection of neurological complications during spine surgery. IONM data derived from sensory spinal and cortical evoked potentials combined with continuous electromyography Monitoring, motor evoked potentials and spinal recording were evaluated in relation to subsequent post-operative neurological changes. Patients were categorised based on their true-positive or true-negative post-operative neurological status. In 2728 consecutive patients we had 909 (33.3%) IONM alerts. We had 8 false negatives (0.3%) with post-operative radicular deficit that completely recovered within 3 months, except for one. There was no false negative for spinal cord injury. 107 were true positives, and 23 were false positives. Multimodal IONM sensitivity and specificity were 93.0% and 99.1%, respectively. The frequency of neurological complications including minor deficits was 4.2% (n = 115), of which 0.37% (n = 10) were permanent. Analysis of the single IONM modalities varied between 13 and 81% to detect neurological complications compared with 93% when using all modalities. Multimodal IONM is more effective and accurate in assessing spinal cord and nerve root function during spine surgeries to reduce both neurological complications and false-negative findings compared to unimodal Monitoring. We recommend multimodal IONM in all complex spine surgeries. These slides can be retrieved from Electronic Supplementary Material.

  • outcome of l5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high grade l5 s1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring
    European Spine Journal, 2017
    Co-Authors: Ralph T. Schär, Martin Sutter, Anne F Mannion, Andreas Eggspuhler, Dezso Jeszenszky, Tamas F Fekete, Frank Kleinstuck, Daniel Haschtmann
    Abstract:

    Purpose To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5–S1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring (IONM).

  • outcome of l5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high grade l5 s1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring
    European Spine Journal, 2017
    Co-Authors: Ralph T. Schär, Martin Sutter, Anne F Mannion, Andreas Eggspuhler, Dezso Jeszenszky, Tamas F Fekete, Frank Kleinstuck, Daniel Haschtmann
    Abstract:

    To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5–S1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring (IONM). Consecutive patients treated for high-grade spondylolisthesis with IONM from 2005 to 2013 were screened for eligibility. Prospectively collected clinical and surgical data as well as radiographic outcomes were analyzed retrospectively. Patients completed the multidimensional Core Outcome Measures Index (COMI) before and at 3, 12, and 24 months after surgery. Seventeen patients were included, with a mean age of 26.3 (±9.5) years. Mean preoperative L5–S1 slip was 72% (±21%) and was reduced to 19% (±13%) postoperatively. Mean loss of reduction at last follow-up [mean 19 months (±14, range 3–48 months)] was 3% (±4.3%). Rate of new L5 radiculopathy with motor deficit (L5MD) after surgery was 29% (five patients). Four patients fully recovered after 3 months, one patient was lost to neurologic follow-up. IONM sensitivity and specificity for postoperative L5MD was 20 and 100%, respectively. COMI, back pain and leg pain scores showed significant (p < 0.001) improvements at 3 months postoperatively, which were retained up to 24 months postoperatively. Transient L5 radiculopathy after reduction and instrumented fusion of high-grade spondylolisthesis is frequent. With IONM the risk of irreversible L5 radiculopathy is minimal. If IONM signal changes recover, full clinical recovery is expected within 3 months. Overall, patient-reported outcome of reduction and instrumented fusion of high-grade spondylolisthesis showed clinically important improvement.

Martin Sutter - One of the best experts on this subject based on the ideXlab platform.

  • the impact and value of uni and multimodal Intraoperative Neurophysiological Monitoring ionm on neurological complications during spine surgery a prospective study of 2728 patients
    European Spine Journal, 2019
    Co-Authors: Martin Sutter, Dezso Jeszenszky, Tamas F Fekete, Daniel Haschtmann, Andreas Eggspuehler, Frank S Kleinstueck, Francois Porchet, Jiri Dvorak
    Abstract:

    We compared the value of different uni- and multimodal Intraoperative Neurophysiological Monitoring (IONM) methods on the detection of neurological complications during spine surgery. IONM data derived from sensory spinal and cortical evoked potentials combined with continuous electromyography Monitoring, motor evoked potentials and spinal recording were evaluated in relation to subsequent post-operative neurological changes. Patients were categorised based on their true-positive or true-negative post-operative neurological status. In 2728 consecutive patients we had 909 (33.3%) IONM alerts. We had 8 false negatives (0.3%) with post-operative radicular deficit that completely recovered within 3 months, except for one. There was no false negative for spinal cord injury. 107 were true positives, and 23 were false positives. Multimodal IONM sensitivity and specificity were 93.0% and 99.1%, respectively. The frequency of neurological complications including minor deficits was 4.2% (n = 115), of which 0.37% (n = 10) were permanent. Analysis of the single IONM modalities varied between 13 and 81% to detect neurological complications compared with 93% when using all modalities. Multimodal IONM is more effective and accurate in assessing spinal cord and nerve root function during spine surgeries to reduce both neurological complications and false-negative findings compared to unimodal Monitoring. We recommend multimodal IONM in all complex spine surgeries. These slides can be retrieved from Electronic Supplementary Material.

  • outcome of l5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high grade l5 s1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring
    European Spine Journal, 2017
    Co-Authors: Ralph T. Schär, Martin Sutter, Anne F Mannion, Andreas Eggspuhler, Dezso Jeszenszky, Tamas F Fekete, Frank Kleinstuck, Daniel Haschtmann
    Abstract:

    Purpose To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5–S1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring (IONM).

  • outcome of l5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high grade l5 s1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring
    European Spine Journal, 2017
    Co-Authors: Ralph T. Schär, Martin Sutter, Anne F Mannion, Andreas Eggspuhler, Dezso Jeszenszky, Tamas F Fekete, Frank Kleinstuck, Daniel Haschtmann
    Abstract:

    To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5–S1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring (IONM). Consecutive patients treated for high-grade spondylolisthesis with IONM from 2005 to 2013 were screened for eligibility. Prospectively collected clinical and surgical data as well as radiographic outcomes were analyzed retrospectively. Patients completed the multidimensional Core Outcome Measures Index (COMI) before and at 3, 12, and 24 months after surgery. Seventeen patients were included, with a mean age of 26.3 (±9.5) years. Mean preoperative L5–S1 slip was 72% (±21%) and was reduced to 19% (±13%) postoperatively. Mean loss of reduction at last follow-up [mean 19 months (±14, range 3–48 months)] was 3% (±4.3%). Rate of new L5 radiculopathy with motor deficit (L5MD) after surgery was 29% (five patients). Four patients fully recovered after 3 months, one patient was lost to neurologic follow-up. IONM sensitivity and specificity for postoperative L5MD was 20 and 100%, respectively. COMI, back pain and leg pain scores showed significant (p < 0.001) improvements at 3 months postoperatively, which were retained up to 24 months postoperatively. Transient L5 radiculopathy after reduction and instrumented fusion of high-grade spondylolisthesis is frequent. With IONM the risk of irreversible L5 radiculopathy is minimal. If IONM signal changes recover, full clinical recovery is expected within 3 months. Overall, patient-reported outcome of reduction and instrumented fusion of high-grade spondylolisthesis showed clinically important improvement.

Ralph T. Schär - One of the best experts on this subject based on the ideXlab platform.

Dezso Jeszenszky - One of the best experts on this subject based on the ideXlab platform.

  • the impact and value of uni and multimodal Intraoperative Neurophysiological Monitoring ionm on neurological complications during spine surgery a prospective study of 2728 patients
    European Spine Journal, 2019
    Co-Authors: Martin Sutter, Dezso Jeszenszky, Tamas F Fekete, Daniel Haschtmann, Andreas Eggspuehler, Frank S Kleinstueck, Francois Porchet, Jiri Dvorak
    Abstract:

    We compared the value of different uni- and multimodal Intraoperative Neurophysiological Monitoring (IONM) methods on the detection of neurological complications during spine surgery. IONM data derived from sensory spinal and cortical evoked potentials combined with continuous electromyography Monitoring, motor evoked potentials and spinal recording were evaluated in relation to subsequent post-operative neurological changes. Patients were categorised based on their true-positive or true-negative post-operative neurological status. In 2728 consecutive patients we had 909 (33.3%) IONM alerts. We had 8 false negatives (0.3%) with post-operative radicular deficit that completely recovered within 3 months, except for one. There was no false negative for spinal cord injury. 107 were true positives, and 23 were false positives. Multimodal IONM sensitivity and specificity were 93.0% and 99.1%, respectively. The frequency of neurological complications including minor deficits was 4.2% (n = 115), of which 0.37% (n = 10) were permanent. Analysis of the single IONM modalities varied between 13 and 81% to detect neurological complications compared with 93% when using all modalities. Multimodal IONM is more effective and accurate in assessing spinal cord and nerve root function during spine surgeries to reduce both neurological complications and false-negative findings compared to unimodal Monitoring. We recommend multimodal IONM in all complex spine surgeries. These slides can be retrieved from Electronic Supplementary Material.

  • outcome of l5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high grade l5 s1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring
    European Spine Journal, 2017
    Co-Authors: Ralph T. Schär, Martin Sutter, Anne F Mannion, Andreas Eggspuhler, Dezso Jeszenszky, Tamas F Fekete, Frank Kleinstuck, Daniel Haschtmann
    Abstract:

    Purpose To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5–S1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring (IONM).

  • outcome of l5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high grade l5 s1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring
    European Spine Journal, 2017
    Co-Authors: Ralph T. Schär, Martin Sutter, Anne F Mannion, Andreas Eggspuhler, Dezso Jeszenszky, Tamas F Fekete, Frank Kleinstuck, Daniel Haschtmann
    Abstract:

    To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5–S1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring (IONM). Consecutive patients treated for high-grade spondylolisthesis with IONM from 2005 to 2013 were screened for eligibility. Prospectively collected clinical and surgical data as well as radiographic outcomes were analyzed retrospectively. Patients completed the multidimensional Core Outcome Measures Index (COMI) before and at 3, 12, and 24 months after surgery. Seventeen patients were included, with a mean age of 26.3 (±9.5) years. Mean preoperative L5–S1 slip was 72% (±21%) and was reduced to 19% (±13%) postoperatively. Mean loss of reduction at last follow-up [mean 19 months (±14, range 3–48 months)] was 3% (±4.3%). Rate of new L5 radiculopathy with motor deficit (L5MD) after surgery was 29% (five patients). Four patients fully recovered after 3 months, one patient was lost to neurologic follow-up. IONM sensitivity and specificity for postoperative L5MD was 20 and 100%, respectively. COMI, back pain and leg pain scores showed significant (p < 0.001) improvements at 3 months postoperatively, which were retained up to 24 months postoperatively. Transient L5 radiculopathy after reduction and instrumented fusion of high-grade spondylolisthesis is frequent. With IONM the risk of irreversible L5 radiculopathy is minimal. If IONM signal changes recover, full clinical recovery is expected within 3 months. Overall, patient-reported outcome of reduction and instrumented fusion of high-grade spondylolisthesis showed clinically important improvement.

Tamas F Fekete - One of the best experts on this subject based on the ideXlab platform.

  • the impact and value of uni and multimodal Intraoperative Neurophysiological Monitoring ionm on neurological complications during spine surgery a prospective study of 2728 patients
    European Spine Journal, 2019
    Co-Authors: Martin Sutter, Dezso Jeszenszky, Tamas F Fekete, Daniel Haschtmann, Andreas Eggspuehler, Frank S Kleinstueck, Francois Porchet, Jiri Dvorak
    Abstract:

    We compared the value of different uni- and multimodal Intraoperative Neurophysiological Monitoring (IONM) methods on the detection of neurological complications during spine surgery. IONM data derived from sensory spinal and cortical evoked potentials combined with continuous electromyography Monitoring, motor evoked potentials and spinal recording were evaluated in relation to subsequent post-operative neurological changes. Patients were categorised based on their true-positive or true-negative post-operative neurological status. In 2728 consecutive patients we had 909 (33.3%) IONM alerts. We had 8 false negatives (0.3%) with post-operative radicular deficit that completely recovered within 3 months, except for one. There was no false negative for spinal cord injury. 107 were true positives, and 23 were false positives. Multimodal IONM sensitivity and specificity were 93.0% and 99.1%, respectively. The frequency of neurological complications including minor deficits was 4.2% (n = 115), of which 0.37% (n = 10) were permanent. Analysis of the single IONM modalities varied between 13 and 81% to detect neurological complications compared with 93% when using all modalities. Multimodal IONM is more effective and accurate in assessing spinal cord and nerve root function during spine surgeries to reduce both neurological complications and false-negative findings compared to unimodal Monitoring. We recommend multimodal IONM in all complex spine surgeries. These slides can be retrieved from Electronic Supplementary Material.

  • outcome of l5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high grade l5 s1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring
    European Spine Journal, 2017
    Co-Authors: Ralph T. Schär, Martin Sutter, Anne F Mannion, Andreas Eggspuhler, Dezso Jeszenszky, Tamas F Fekete, Frank Kleinstuck, Daniel Haschtmann
    Abstract:

    Purpose To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5–S1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring (IONM).

  • outcome of l5 radiculopathy after reduction and instrumented transforaminal lumbar interbody fusion of high grade l5 s1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring
    European Spine Journal, 2017
    Co-Authors: Ralph T. Schär, Martin Sutter, Anne F Mannion, Andreas Eggspuhler, Dezso Jeszenszky, Tamas F Fekete, Frank Kleinstuck, Daniel Haschtmann
    Abstract:

    To evaluate the incidence and course of iatrogenic L5 radiculopathy after reduction and instrumented fusion of high-grade L5–S1 isthmic spondylolisthesis and the role of Intraoperative Neurophysiological Monitoring (IONM). Consecutive patients treated for high-grade spondylolisthesis with IONM from 2005 to 2013 were screened for eligibility. Prospectively collected clinical and surgical data as well as radiographic outcomes were analyzed retrospectively. Patients completed the multidimensional Core Outcome Measures Index (COMI) before and at 3, 12, and 24 months after surgery. Seventeen patients were included, with a mean age of 26.3 (±9.5) years. Mean preoperative L5–S1 slip was 72% (±21%) and was reduced to 19% (±13%) postoperatively. Mean loss of reduction at last follow-up [mean 19 months (±14, range 3–48 months)] was 3% (±4.3%). Rate of new L5 radiculopathy with motor deficit (L5MD) after surgery was 29% (five patients). Four patients fully recovered after 3 months, one patient was lost to neurologic follow-up. IONM sensitivity and specificity for postoperative L5MD was 20 and 100%, respectively. COMI, back pain and leg pain scores showed significant (p < 0.001) improvements at 3 months postoperatively, which were retained up to 24 months postoperatively. Transient L5 radiculopathy after reduction and instrumented fusion of high-grade spondylolisthesis is frequent. With IONM the risk of irreversible L5 radiculopathy is minimal. If IONM signal changes recover, full clinical recovery is expected within 3 months. Overall, patient-reported outcome of reduction and instrumented fusion of high-grade spondylolisthesis showed clinically important improvement.