According to a recent news release, the American Academy of Neurology (AAN) has issued an updated guideline, which recommends that the spinal cord be monitored during spinal surgery, and certain chest surgeries in order to protect against paralysis or loss of muscle function related to the surgeries. The guideline was reportedly developed by the American Clinical Neurophysiology Society and appears in the February issue of Neurology and the Journal of Clinical Neurophysiology.
The guideline spotlights evidence that suggests monitoring the spinal cord during spinal surgery and certain chest surgeries, such as those performed to repair the narrowing of the walls of the aorta may assist in preventing paralysis associated with the surgery. The release adds that the procedure is designed to help alert the surgeon in time to find and address any potential problems before damage occurs.
Marc R. Nuwer, MD, PhD, University of California, Los Angeles, and fellow of the AAN, served as the guideline’s lead author. Nuwer reinforces the guideline’s recommendation, “Monitoring can help prevent damage by identifying problems early enough to allow for interventions. If intraoperative monitoring raises warnings, surgeons and anesthesiologists can modify the surgery to reduce the risk of these complications,” Nuwer explains.
Researchers explain that intraoperative monitoring of the spinal cord encompasses the monitoring of somatosensory evoked potential (SEPs) and motor evoked potentials (MEPs). According to the new guideline, in cases where paralysis occurred, the patients exhibited changes in their evoked potentials during surgery, compared to patients without any changes in their evoked potentials who exhibited no cases of paralysis.
Nuwer emphasizes that prevention is the best approach in treating paralysis and adds that, “Spinal cord monitoring supervised by a neurologist can help meet this goal.”