| CODE | CBC5203 | |||||||||
| TITLE | Intra-Operative Neuro Monitoring | |||||||||
| UM LEVEL | 05 - Postgraduate Modular Diploma or Degree Course | |||||||||
| MQF LEVEL | 7 | |||||||||
| ECTS CREDITS | 10 | |||||||||
| DEPARTMENT | Centre for Biomedical Cybernetics | |||||||||
| DESCRIPTION | This study-unit provides in-depth training in the technical aspects of intra-operative neurophysiological monitoring (IONM). Students will focus on designing, implementing, and evaluating techniques for monitoring sensory and motor pathways during surgery, including Electroencephalography (EEG), Somatosensory Evoked Potentials (SEPs), Motor Evoked Potentials (MEPs), and electromyography (EMG). Key technical skills include peri-operative monitoring of spinal cord pathways, performing epidural recordings, and using pedicle screw stimulation to ensure bone integrity. The study-unit covers the effects of anaesthesia on neurophysiological recordings and teaches advanced methods for acquiring and interpreting data in real-time. Additionally, students will gain expertise in troubleshooting equipment, analysing neurophysiological data during surgery, and applying the latest technological advancements to improve monitoring accuracy and patient safety. Study-Unit Aims: - To ensure that students are able to apply neurophysiological techniques to monitor the functional integrity of the sensory and motor spinal cord and peripheral neural structures during orthopedic and neurosurgery, in and around the spine; - To ensure that students are able to critically apply their knowledge of spinal monitoring; - To ensure that students are able to identify any significant neurophysiological changes recorded intra-operatively and their underlying pathophysiology; - To ensure that students have the necessary communication skills to effectively communicate significant neurophysiological changes to a multidisciplinary team, particularly including the anaesthetic and surgical team; - To ensure that students are able to generate an informative report on the monitoring data recorded intra-operatively. Learning Outcomes: 1. Knowledge & Understanding: By the end of the study-unit the student will be able to: - Assess the pre-operative clinical and neurological status, formulate the form/type of monitoring required and, based on the effect of anaesthesia, determine the recording regime; - Design and implement appropriate peri-operative in-theatre recording techniques for the sensory and motor spinal cord pathways; - Perform peri-operative in-theatre techniques to obtain: Electroencephalographic (EEG) potentials; Somatosensory Evoked Potentials (SEPs) and Motor Evoked Potentials (MEPs), in and around the cervical, thoracic and lumbar regions; free-running electromyography (EMG) of selected muscle groups to evaluate and map nerve roots; - Perform peri-operative in-theatre epidural recording techniques for the monitoring for the sensory and motor spinal cord pathways; - Perform peri-operative in-theatre pedicle screw stimulation techniques to ensure the integrity of the bone; - Interpret and analyse neurophysiological recordings (EEG, SEPs, MEPs, EMG) acquired during surgery, placing the results in the context of patient history, clinical examination and surgical procedure being carried out; - Identify effects of anaesthetic agents, physiological variables and surgical manoeuvres on recordings; - Practise effective communication of any significant neurophysiological changes recorded and their underlying pathophysiology with a multidisciplinary team, particularly including the anaesthetic and surgical team; - Construct a clear, informative clinical report; - Identify and implement new and improved technologies related to intra-operative monitoring. 2. Skills: By the end of the study-unit the student will be able to: - Formulate the form/type of monitoring required based on the patient's pre-operative clinical and neurological status; - Implement monitoring techniques, including EEG, SEPs, MEPs, EMG; - Interpret and identify any significant neurophysiological changes recorded and their underlying pathophysiology; - Communicate effectively within a multidisciplinary team, particularly including the anaesthetic and surgical team; - Construct a comprehensive report of the monitoring. Main Readings: - Deletis, V., Shils, J. L., Sala, F., & Seidel, K. (Eds.). (2020). Neurophysiology in Neurosurgery: a Modern Approach. Academic Press. - Zentner, J., MacDonald, D. B., & Wegner, C. (2024). Intraoperative Neuromonitoring: Fundamentals, Possibilities, Limitations. Springer Nature. |
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| ADDITIONAL NOTES | Pre-Requisite Study-units: CBC5201, CBC5202 | |||||||||
| STUDY-UNIT TYPE | Lecture, Placement and Tutorial | |||||||||
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The University makes every effort to ensure that the published Courses Plans, Programmes of Study and Study-Unit information are complete and up-to-date at the time of publication. The University reserves the right to make changes in case errors are detected after publication.
The availability of optional units may be subject to timetabling constraints. Units not attracting a sufficient number of registrations may be withdrawn without notice. It should be noted that all the information in the description above applies to study-units available during the academic year 2025/6. It may be subject to change in subsequent years. |
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