Authors (including presenting author) :
Wong LS(1), Wong TF(1), Sin TN(1), So SS(1)
Affiliation :
(1) Department of Orthopaedics & Traumatology, Tuen Mun Hospital
Introduction :
Intraoperative Neurophysiological Monitoring (IOM) is employed since 2014 for our spine surgery in the Department of Orthopaedics and Traumatology, NTWC. Aims to provide neurophysiological information for surgeon to guide the intraoperative decision and to minimize postoperative deficit, especially in high-risk surgery such as deformity correction and cervical spine surgery. The monitoring procedure was performed and monitored by O&T specialty nurses during operation. It can enhance the communication of anesthetists, surgeons and specialty nurses in patient care. According to the service needs, it also extended to the spine surgery in POH in June 2017.
Objectives :
1 Provide additional intra-operative neurophysiology monitoring to surgeon
when working in delicate surgery.
2 Reduces risk of iatrogenic injury.
3 To improve patient outcome with low incidence of complication, as well as
a high patient satisfaction. Enhance a safe and high quality service for
patients with spine surgery.
4 To enhance the knowledge and experience of specialty nurses to carry out
IOM and collaborate with doctors to provide quality care to patients
Methodology :
The spine surgeons selected the suitable spine operation cases for IOM. In pre-operative phase, specialty nurses assessed the patients and explained the procedure for IOM. They performed close monitoring the signal change and informed surgeons at once if any abnormality according to the warning criteria. The surgeons would take prompt action during operation. Meanwhile, specialty nurses have attended the overseas attachment in the United States for gaining experience and knowledge in the monitoring.
Result & Outcome :
From 1st April, 2014 to 31st December, 2021 total 308 cases were performed IOM in spine operation in NTWC. The sensitivity and specificity of IOM in spine surgery was 100% and 82% respectively. And there was no neurological deficit was detected. Patient's feedback was encouraged and decreased their anxiety of the operation.In nurse specialty training and development in IOM are paramount that recognize the advance standard of specialty nursing.
