Current trends in intraoperative neurophysiological monitoring among Asia–Pacific countries: an Asia–Pacific Spine Society survey

Study Design A prospective web-based survey. Purpose Although intraoperative neurophysiological monitoring (IONM) is critical in spine surgery, its usage is largely based on the surgeon’s discretion, and studies on its usage trends in Asia–Pacific countries are lacking. This study aimed to examine c...

Full description

Saved in:
Bibliographic Details
Main Authors: Hideki Shigematsu, Akimasa Yasuda, Ronald Tangente, Chris Yin Wei Chan, Ajoy Prasad Shetty, Jason Pui Yin Cheung, Yong Hai, Daisuke Sakai, Kyu-Jung Cho, Chih-Wei Chen, Gabriel Liu, I Gusti Lanang Ngurah Agung Artha Wiguna, Brian Hsu, Mun Keong Kwan
Format: Article
Language:English
Published: Korean Spine Society 2024-12-01
Series:Asian Spine Journal
Subjects:
Online Access:http://asianspinejournal.org/upload/pdf/asj-2024-0273.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849309612337004544
author Hideki Shigematsu
Akimasa Yasuda
Ronald Tangente
Chris Yin Wei Chan
Ajoy Prasad Shetty
Jason Pui Yin Cheung
Yong Hai
Daisuke Sakai
Kyu-Jung Cho
Chih-Wei Chen
Gabriel Liu
I Gusti Lanang Ngurah Agung Artha Wiguna
Brian Hsu
Mun Keong Kwan
author_facet Hideki Shigematsu
Akimasa Yasuda
Ronald Tangente
Chris Yin Wei Chan
Ajoy Prasad Shetty
Jason Pui Yin Cheung
Yong Hai
Daisuke Sakai
Kyu-Jung Cho
Chih-Wei Chen
Gabriel Liu
I Gusti Lanang Ngurah Agung Artha Wiguna
Brian Hsu
Mun Keong Kwan
author_sort Hideki Shigematsu
collection DOAJ
description Study Design A prospective web-based survey. Purpose Although intraoperative neurophysiological monitoring (IONM) is critical in spine surgery, its usage is largely based on the surgeon’s discretion, and studies on its usage trends in Asia–Pacific countries are lacking. This study aimed to examine current trends in IONM usage in Asia–Pacific countries. Overview of Literature IONM is an important tool for minimizing neurological complications and detecting spinal cord injuries after spine surgery. IONM can be performed using several modalities, such as transcranial electrical stimulation-muscle evoked potentials (Tc-MEP) and somatosensory evoked potentials (SEP). Methods Spine surgeons of the Asia–Pacific Spine Society were asked to respond to a web-based survey on IONM. The questionnaire covered various aspects of IONM, including its common modality, Tc-MEP details, necessities for consistent use, and recommended modalities in major spine surgeries and representative surgical procedures. Results Responses were received from 193 of 626 spine surgeons. Among these respondents, 177 used IONM routinely. Among these 177 respondents, 17 mainly used SEP, whereas the majority favored Tc-MEPs. Although a >50% decrease is the commonly used alarm point in Tc-MEP, half of the Tc-MEP users had no protocols planned for such scenarios. Moreover, half of the Tc-MEP users experienced complications, with bite injuries being the most common. Most respondents strongly recommended IONM in deformity surgery for pediatric and adult populations and tumor resection surgery for intramedullary spinal cord tumors. Conversely, IONM was the least recommended in lumbar spinal canal stenosis surgery. Conclusions Spine surgeons in Asia–Pacific countries favored IONM use, indicating widespread routine utilization. Tc-MEP was the predominant modality for IONM, followed by SEPs.
format Article
id doaj-art-c0955bcd36fd4e5b8a5211349b879bfc
institution Kabale University
issn 1976-1902
1976-7846
language English
publishDate 2024-12-01
publisher Korean Spine Society
record_format Article
series Asian Spine Journal
spelling doaj-art-c0955bcd36fd4e5b8a5211349b879bfc2025-08-20T03:54:01ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462024-12-0118681382110.31616/asj.2024.02731690Current trends in intraoperative neurophysiological monitoring among Asia–Pacific countries: an Asia–Pacific Spine Society surveyHideki Shigematsu0Akimasa Yasuda1Ronald Tangente2Chris Yin Wei Chan3Ajoy Prasad Shetty4Jason Pui Yin Cheung5Yong Hai6Daisuke Sakai7Kyu-Jung Cho8Chih-Wei Chen9Gabriel Liu10I Gusti Lanang Ngurah Agung Artha Wiguna11Brian Hsu12Mun Keong Kwan13 Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan Department of Orthopaedic Surgery, National Hospital Organization Saitama Hospital, Wako, Japan Orthopedic Center, Davao Doctors Hospital, Davao City, Philippines Orthopaedic Surgery Department, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Department of Orthopaedic Surgery, Ganga Medical Centre and Hospitals, Coimbatore, India Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong Department of Orthopaedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China Department of Orthopaedic Surgery, Tokai University School of Medicine, Isehara, Japan Department of Orthopaedic Surgery, Inha University Hospital, Incheon, Korea Department of Orthopaedics, National Taiwan University Hospital, Taipei, Taiwan Department of Orthopaedic Surgery, National University Health System, Singapore Department of Orthopaedics and Traumatology, Prof. Ngoerah Hospital (Sanglah General Hospital), Denpasar, Indonesia Department of Orthopaedics, The Children’s Hospital at Westmead, Sydney, NSW, Australia Orthopaedic Surgery Department, Faculty of Medicine, University of Malaya, Kuala Lumpur, MalaysiaStudy Design A prospective web-based survey. Purpose Although intraoperative neurophysiological monitoring (IONM) is critical in spine surgery, its usage is largely based on the surgeon’s discretion, and studies on its usage trends in Asia–Pacific countries are lacking. This study aimed to examine current trends in IONM usage in Asia–Pacific countries. Overview of Literature IONM is an important tool for minimizing neurological complications and detecting spinal cord injuries after spine surgery. IONM can be performed using several modalities, such as transcranial electrical stimulation-muscle evoked potentials (Tc-MEP) and somatosensory evoked potentials (SEP). Methods Spine surgeons of the Asia–Pacific Spine Society were asked to respond to a web-based survey on IONM. The questionnaire covered various aspects of IONM, including its common modality, Tc-MEP details, necessities for consistent use, and recommended modalities in major spine surgeries and representative surgical procedures. Results Responses were received from 193 of 626 spine surgeons. Among these respondents, 177 used IONM routinely. Among these 177 respondents, 17 mainly used SEP, whereas the majority favored Tc-MEPs. Although a >50% decrease is the commonly used alarm point in Tc-MEP, half of the Tc-MEP users had no protocols planned for such scenarios. Moreover, half of the Tc-MEP users experienced complications, with bite injuries being the most common. Most respondents strongly recommended IONM in deformity surgery for pediatric and adult populations and tumor resection surgery for intramedullary spinal cord tumors. Conversely, IONM was the least recommended in lumbar spinal canal stenosis surgery. Conclusions Spine surgeons in Asia–Pacific countries favored IONM use, indicating widespread routine utilization. Tc-MEP was the predominant modality for IONM, followed by SEPs.http://asianspinejournal.org/upload/pdf/asj-2024-0273.pdfintraoperative neurophysiological monitoringtranscranial electrical stimulationsomatosensory evoked potentialsasia-pacific
spellingShingle Hideki Shigematsu
Akimasa Yasuda
Ronald Tangente
Chris Yin Wei Chan
Ajoy Prasad Shetty
Jason Pui Yin Cheung
Yong Hai
Daisuke Sakai
Kyu-Jung Cho
Chih-Wei Chen
Gabriel Liu
I Gusti Lanang Ngurah Agung Artha Wiguna
Brian Hsu
Mun Keong Kwan
Current trends in intraoperative neurophysiological monitoring among Asia–Pacific countries: an Asia–Pacific Spine Society survey
Asian Spine Journal
intraoperative neurophysiological monitoring
transcranial electrical stimulation
somatosensory evoked potentials
asia-pacific
title Current trends in intraoperative neurophysiological monitoring among Asia–Pacific countries: an Asia–Pacific Spine Society survey
title_full Current trends in intraoperative neurophysiological monitoring among Asia–Pacific countries: an Asia–Pacific Spine Society survey
title_fullStr Current trends in intraoperative neurophysiological monitoring among Asia–Pacific countries: an Asia–Pacific Spine Society survey
title_full_unstemmed Current trends in intraoperative neurophysiological monitoring among Asia–Pacific countries: an Asia–Pacific Spine Society survey
title_short Current trends in intraoperative neurophysiological monitoring among Asia–Pacific countries: an Asia–Pacific Spine Society survey
title_sort current trends in intraoperative neurophysiological monitoring among asia pacific countries an asia pacific spine society survey
topic intraoperative neurophysiological monitoring
transcranial electrical stimulation
somatosensory evoked potentials
asia-pacific
url http://asianspinejournal.org/upload/pdf/asj-2024-0273.pdf
work_keys_str_mv AT hidekishigematsu currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT akimasayasuda currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT ronaldtangente currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT chrisyinweichan currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT ajoyprasadshetty currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT jasonpuiyincheung currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT yonghai currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT daisukesakai currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT kyujungcho currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT chihweichen currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT gabrielliu currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT igustilanangngurahagungarthawiguna currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT brianhsu currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey
AT munkeongkwan currenttrendsinintraoperativeneurophysiologicalmonitoringamongasiapacificcountriesanasiapacificspinesocietysurvey