Welcome to the first issue of the New Year 2023.
Intraoperative neurophysiological monitoring (IONM) is now being used in many centers in India and has become a great tool in improving the quality of neurosurgery and end results in brain and spine surgeries. Although it is mandatory in epilepsy surgery, the utility in spinal surgery is fast picking up with diverse opinions at the beginning stage.
Few months ago, I had the opportunity of attending the conference on IONM at Chennai and it was a pleasure to see a society being formed to develop this specialty in the armamentarium of neurosurgery with collaboration from neurosurgeons, neurologists, neuroanesthesiologists, neurophysiologists, and neurophysiology technicians.
The article on IONM and its utility in spinal cord intramedullary tumor is well written by the team led by Dr. Parthasarathy Thirumala. The predictive values are dependent on many factors, namely quality of neurotechnicians, the interpreters, anesthetists, and neurosurgeons. Hence, the learning curve is slow and moderate at the beginning stage but improves over a period of time when the whole team gels up as one unit. Although literature is flooded with scientific articles on IONM and its utility in intramedullary spinal cord tumors with diverse views, it is clear now that multi-modal IONM is mandatory in this area, particularly using motor-evoked potentials, somatosensory-evoked potentials, and D-wave all together in a case. This will certainly help surgeons in removing complex tumors safely and also police young surgeons venturing in this area. This article written by Thirumala’s team is a boon to the readers.
That apart the article on posterior reversible encephalopathy syndrome in spinal surgeries is an eye-opener for all.
Wish all members of NSSA a great year ahead and wish more articles are submitted for publication.