'The utility of routine ION for ACDFs is questionable': 5 notes on intraoperative neuromonitoring study

Spine

A new study published in Spine examined intraoperative neuromonitoring for anterior cervical discectomy and fusion patients.

The study examined 15,395 patients who underwent ACDF surgery from 2007 to 2014. The authors performed a retrospective review using the PearlDiver Patient Record Database. Surgeons used intraoperative neuromonitoring in 2,627 cases — 17 percent of the cases. The researchers found:

 

1. ION use decreased over time, with 22.8 percent of ACDF cases including ION in 2007 and 4.3 percent of cases including ION in 2014.

 

2. ION modalities were variable:

 

• Somatosensory-evoked potentials: 48.7 percent
• Motor-evoked potentials: 5.3 percent
• Combined SSEPs and MEPs: 46.1 percent

 

3. Neurological complications were reported in 0.23 percent of the ION patients and 0.27 percent of the non-ION patients.

 

4. Surgeons were more likely to use ION for younger patients.

 

5. There was variability among regions of the country for ION use with 12.9 percent of ACDF cases in the Midwest including ION and 21.9 percent of cases in the West including ION.

 

"The utility of routine ION for ACDFs is questionable," concluded the study authors.

 

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