Optimising MEPs in spinal cor monitoring and the role of anesthesia

Description

This talk was part of an educational session about IONM
Chari: Gea Drost and Alida Gouw
Introduction:
Intraoperative neurophysiological monitoring (IONM) has become an important tool in an increasing number of surgeries to avoid permanent damage to the nervous system. In various neurosurgical procedures, there is a substantial risk of permanent damage to the brain, brainstem, and cranial nerves. Additionally, in diverse vascular and orthopedic surgeries there is a risk of damage to the spinal cord, nerve roots and/or peripheral nerves.
Unlike other neurophysiological assessments, IONM demands immediate and simultaneous interpretation of multimodal neurophysiological signals. Effective communication with the surgical and anesthesiology team is essential to prevent permanent nervous system damage. Yet, the practical aspects of IONM modalities varies across different centers and countries, and sharing experiences among IONM teams can significantly advance the field.

Teaching session overview: This session will feature IONM specialists in orthopedic, vascular and especially the neurosurgical field.

Goal: Our goal is to provide a comprehensive overview of optimal multimodal monitoring in various surgeries and present the latest scientific insights on IONM techniques.

Key focus Areas:
1. Optimization of the techniques and interpretation of:
o basic cortico-spinal monitoring (motor evoked potentials, D-waves)
o somatosensory evoked potentials in spinal cord surgery
2. Advanced Monitoring:
o monitoring of corticobulbar tracts/cranial nerves in brain(stem) surgery (corticobulbar motor evoked potentials)
o potential novel modalities including late responses and reflexes.

Illustrative Cases: Through illustrative cases, we will demonstrate that IONM is a collaborative effort involving the entire surgical team, the anaesthesiology team, and not just the IONM team.

Conclusion: By sharing knowledge and experiences, we aim to improve the practical execution of IONM techniques, ultimately optimizing patient outcomes in high-risk surgeries.

Period	9-Sept-2025
Held at	ECCN 2025 London
Degree of Recognition	International