Best practices in intraoperative neuromonitoring in spine deformity surgery

Development of an intraoperative checklist to optimize response

Michael G. Vitale, David L. Skaggs, Gregory I. Pace, Margaret L. Wright, Hiroko Matsumoto, Richard C E Anderson, Douglas L. Brockmeyer, John P. Dormans, John B. Emans, Mark A. Erickson, John M. Flynn, Michael P. Glotzbecker, Kamal N. Ibrahim, Stephen J. Lewis, Scott J. Luhmann, Anil Mendiratta, B. Stephens Richards, James O. Sanders, Suken A. Shah, John T. Smith & 5 others Kit M. Song, Paul D. Sponseller, Daniel J. Sucato, David P. Roye, Lawrence G. Lenke

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Study Design Consensus-based creation of a checklist and guideline. Objective To develop a consensus-based checklist to guide surgeon responses to intraoperative neuromonitoring (IONM) changes in patients with a stable spine and to develop a consensus-based best practice guideline for IONM practice in the United States. Summary of Background Data Studies show that checklists enhance surgical team responses to crisis situations and improve patient outcomes. Currently, no widely accepted guidelines exist for the response to IONM changes in spine deformity surgery. Methods After a literature review of risk factors and recommendations for responding to IONM changes, 4 surveys were administered to 21 experienced spine surgeons and 1 neurologist experienced in IONM. Areas of equipoise were identified and the nominal group process was used to determine items to be included in the checklist. The authors reevaluated and modified the checklist at 3 face-to-face meetings over 12 months, including a period of clinical validation using a modified Delphi process. The group was also surveyed on current IONM practices at their institutions. This information and existing IONM position statements were used to create the IONM best practice guideline. Results Consensus was reached for the creation of 5 checklist headings containing 26 items to consider in the response to IONM changes. Consensus was reached on 5 statements for inclusion in the best practice guideline; the final guideline promotes a team approach and makes recommendations aimed at decreasing variability in neuromonitoring practices. Conclusions The final products represent the consensus of a group of expert spine surgeons. The checklist includes the most important and high-yield items to consider when responding to IONM changes in patients with a stable spine, whereas the IONM guideline represents the group consensus on items that should be considered best practice among IONM teams with the appropriate resources.

Original languageEnglish (US)
Pages (from-to)333-339
Number of pages7
JournalSpine Deformity
Volume2
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Checklist
Practice Guidelines
Consensus
Spine
Guidelines
Group Processes
Surgeons

Keywords

  • Neuromonitoring
  • Spine deformity surgery
  • Surgical checklist

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Vitale, M. G., Skaggs, D. L., Pace, G. I., Wright, M. L., Matsumoto, H., Anderson, R. C. E., ... Lenke, L. G. (2014). Best practices in intraoperative neuromonitoring in spine deformity surgery: Development of an intraoperative checklist to optimize response. Spine Deformity, 2(5), 333-339. https://doi.org/10.1016/j.jspd.2014.05.003

Best practices in intraoperative neuromonitoring in spine deformity surgery : Development of an intraoperative checklist to optimize response. / Vitale, Michael G.; Skaggs, David L.; Pace, Gregory I.; Wright, Margaret L.; Matsumoto, Hiroko; Anderson, Richard C E; Brockmeyer, Douglas L.; Dormans, John P.; Emans, John B.; Erickson, Mark A.; Flynn, John M.; Glotzbecker, Michael P.; Ibrahim, Kamal N.; Lewis, Stephen J.; Luhmann, Scott J.; Mendiratta, Anil; Richards, B. Stephens; Sanders, James O.; Shah, Suken A.; Smith, John T.; Song, Kit M.; Sponseller, Paul D.; Sucato, Daniel J.; Roye, David P.; Lenke, Lawrence G.

In: Spine Deformity, Vol. 2, No. 5, 2014, p. 333-339.

Research output: Contribution to journalArticle

Vitale, MG, Skaggs, DL, Pace, GI, Wright, ML, Matsumoto, H, Anderson, RCE, Brockmeyer, DL, Dormans, JP, Emans, JB, Erickson, MA, Flynn, JM, Glotzbecker, MP, Ibrahim, KN, Lewis, SJ, Luhmann, SJ, Mendiratta, A, Richards, BS, Sanders, JO, Shah, SA, Smith, JT, Song, KM, Sponseller, PD, Sucato, DJ, Roye, DP & Lenke, LG 2014, 'Best practices in intraoperative neuromonitoring in spine deformity surgery: Development of an intraoperative checklist to optimize response', Spine Deformity, vol. 2, no. 5, pp. 333-339. https://doi.org/10.1016/j.jspd.2014.05.003
Vitale, Michael G. ; Skaggs, David L. ; Pace, Gregory I. ; Wright, Margaret L. ; Matsumoto, Hiroko ; Anderson, Richard C E ; Brockmeyer, Douglas L. ; Dormans, John P. ; Emans, John B. ; Erickson, Mark A. ; Flynn, John M. ; Glotzbecker, Michael P. ; Ibrahim, Kamal N. ; Lewis, Stephen J. ; Luhmann, Scott J. ; Mendiratta, Anil ; Richards, B. Stephens ; Sanders, James O. ; Shah, Suken A. ; Smith, John T. ; Song, Kit M. ; Sponseller, Paul D. ; Sucato, Daniel J. ; Roye, David P. ; Lenke, Lawrence G. / Best practices in intraoperative neuromonitoring in spine deformity surgery : Development of an intraoperative checklist to optimize response. In: Spine Deformity. 2014 ; Vol. 2, No. 5. pp. 333-339.
@article{aff283166f6f4c6eab1de5152cc74b74,
title = "Best practices in intraoperative neuromonitoring in spine deformity surgery: Development of an intraoperative checklist to optimize response",
abstract = "Study Design Consensus-based creation of a checklist and guideline. Objective To develop a consensus-based checklist to guide surgeon responses to intraoperative neuromonitoring (IONM) changes in patients with a stable spine and to develop a consensus-based best practice guideline for IONM practice in the United States. Summary of Background Data Studies show that checklists enhance surgical team responses to crisis situations and improve patient outcomes. Currently, no widely accepted guidelines exist for the response to IONM changes in spine deformity surgery. Methods After a literature review of risk factors and recommendations for responding to IONM changes, 4 surveys were administered to 21 experienced spine surgeons and 1 neurologist experienced in IONM. Areas of equipoise were identified and the nominal group process was used to determine items to be included in the checklist. The authors reevaluated and modified the checklist at 3 face-to-face meetings over 12 months, including a period of clinical validation using a modified Delphi process. The group was also surveyed on current IONM practices at their institutions. This information and existing IONM position statements were used to create the IONM best practice guideline. Results Consensus was reached for the creation of 5 checklist headings containing 26 items to consider in the response to IONM changes. Consensus was reached on 5 statements for inclusion in the best practice guideline; the final guideline promotes a team approach and makes recommendations aimed at decreasing variability in neuromonitoring practices. Conclusions The final products represent the consensus of a group of expert spine surgeons. The checklist includes the most important and high-yield items to consider when responding to IONM changes in patients with a stable spine, whereas the IONM guideline represents the group consensus on items that should be considered best practice among IONM teams with the appropriate resources.",
keywords = "Neuromonitoring, Spine deformity surgery, Surgical checklist",
author = "Vitale, {Michael G.} and Skaggs, {David L.} and Pace, {Gregory I.} and Wright, {Margaret L.} and Hiroko Matsumoto and Anderson, {Richard C E} and Brockmeyer, {Douglas L.} and Dormans, {John P.} and Emans, {John B.} and Erickson, {Mark A.} and Flynn, {John M.} and Glotzbecker, {Michael P.} and Ibrahim, {Kamal N.} and Lewis, {Stephen J.} and Luhmann, {Scott J.} and Anil Mendiratta and Richards, {B. Stephens} and Sanders, {James O.} and Shah, {Suken A.} and Smith, {John T.} and Song, {Kit M.} and Sponseller, {Paul D.} and Sucato, {Daniel J.} and Roye, {David P.} and Lenke, {Lawrence G.}",
year = "2014",
doi = "10.1016/j.jspd.2014.05.003",
language = "English (US)",
volume = "2",
pages = "333--339",
journal = "Spine Deformity",
issn = "2212-134X",
publisher = "Elsevier BV",
number = "5",

}

TY - JOUR

T1 - Best practices in intraoperative neuromonitoring in spine deformity surgery

T2 - Development of an intraoperative checklist to optimize response

AU - Vitale, Michael G.

AU - Skaggs, David L.

AU - Pace, Gregory I.

AU - Wright, Margaret L.

AU - Matsumoto, Hiroko

AU - Anderson, Richard C E

AU - Brockmeyer, Douglas L.

AU - Dormans, John P.

AU - Emans, John B.

AU - Erickson, Mark A.

AU - Flynn, John M.

AU - Glotzbecker, Michael P.

AU - Ibrahim, Kamal N.

AU - Lewis, Stephen J.

AU - Luhmann, Scott J.

AU - Mendiratta, Anil

AU - Richards, B. Stephens

AU - Sanders, James O.

AU - Shah, Suken A.

AU - Smith, John T.

AU - Song, Kit M.

AU - Sponseller, Paul D.

AU - Sucato, Daniel J.

AU - Roye, David P.

AU - Lenke, Lawrence G.

PY - 2014

Y1 - 2014

N2 - Study Design Consensus-based creation of a checklist and guideline. Objective To develop a consensus-based checklist to guide surgeon responses to intraoperative neuromonitoring (IONM) changes in patients with a stable spine and to develop a consensus-based best practice guideline for IONM practice in the United States. Summary of Background Data Studies show that checklists enhance surgical team responses to crisis situations and improve patient outcomes. Currently, no widely accepted guidelines exist for the response to IONM changes in spine deformity surgery. Methods After a literature review of risk factors and recommendations for responding to IONM changes, 4 surveys were administered to 21 experienced spine surgeons and 1 neurologist experienced in IONM. Areas of equipoise were identified and the nominal group process was used to determine items to be included in the checklist. The authors reevaluated and modified the checklist at 3 face-to-face meetings over 12 months, including a period of clinical validation using a modified Delphi process. The group was also surveyed on current IONM practices at their institutions. This information and existing IONM position statements were used to create the IONM best practice guideline. Results Consensus was reached for the creation of 5 checklist headings containing 26 items to consider in the response to IONM changes. Consensus was reached on 5 statements for inclusion in the best practice guideline; the final guideline promotes a team approach and makes recommendations aimed at decreasing variability in neuromonitoring practices. Conclusions The final products represent the consensus of a group of expert spine surgeons. The checklist includes the most important and high-yield items to consider when responding to IONM changes in patients with a stable spine, whereas the IONM guideline represents the group consensus on items that should be considered best practice among IONM teams with the appropriate resources.

AB - Study Design Consensus-based creation of a checklist and guideline. Objective To develop a consensus-based checklist to guide surgeon responses to intraoperative neuromonitoring (IONM) changes in patients with a stable spine and to develop a consensus-based best practice guideline for IONM practice in the United States. Summary of Background Data Studies show that checklists enhance surgical team responses to crisis situations and improve patient outcomes. Currently, no widely accepted guidelines exist for the response to IONM changes in spine deformity surgery. Methods After a literature review of risk factors and recommendations for responding to IONM changes, 4 surveys were administered to 21 experienced spine surgeons and 1 neurologist experienced in IONM. Areas of equipoise were identified and the nominal group process was used to determine items to be included in the checklist. The authors reevaluated and modified the checklist at 3 face-to-face meetings over 12 months, including a period of clinical validation using a modified Delphi process. The group was also surveyed on current IONM practices at their institutions. This information and existing IONM position statements were used to create the IONM best practice guideline. Results Consensus was reached for the creation of 5 checklist headings containing 26 items to consider in the response to IONM changes. Consensus was reached on 5 statements for inclusion in the best practice guideline; the final guideline promotes a team approach and makes recommendations aimed at decreasing variability in neuromonitoring practices. Conclusions The final products represent the consensus of a group of expert spine surgeons. The checklist includes the most important and high-yield items to consider when responding to IONM changes in patients with a stable spine, whereas the IONM guideline represents the group consensus on items that should be considered best practice among IONM teams with the appropriate resources.

KW - Neuromonitoring

KW - Spine deformity surgery

KW - Surgical checklist

UR - http://www.scopus.com/inward/record.url?scp=84906830900&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906830900&partnerID=8YFLogxK

U2 - 10.1016/j.jspd.2014.05.003

DO - 10.1016/j.jspd.2014.05.003

M3 - Article

VL - 2

SP - 333

EP - 339

JO - Spine Deformity

JF - Spine Deformity

SN - 2212-134X

IS - 5

ER -