PROTECT, ASSESS & CONFIRM

MAPPING

  • Reliably locate nerves in altered anatomy or anytime nerves are at risk
  • Map location of nerve through tissue
  • Localize nerve tissue obscured by scarring, tumor or bone

ASSESSMENT

  • Determine stimulation threshold for motor response
  • Test for changes in nerve function throughout the procedure
  • Stimulate muscle to evaluate excursion in tendon and free muscle transfers

ELICITING A TETANIC CONTRACTION

  • Confirm whether a tissue structure is a nerve
  • Confirm with full tetanic contraction (vs a “twitch”)
  • Identify individual fascicle groups within a nerve

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Helpful Resources

References

  1. Top Five Rules to Avoid Neurovascular Injury During Total Shoulder Arthroplasty. Evan Flatow, MD, and Victor Olujimi, MD Leni & Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mt. Sinai, NYC, NY Seminars in Arthroplasty, March 2017. Volume 28, Issue 1, Pages 2-4.

  2. Intraoperative Nerve Monitoring With a Handheld Intraoperative Biphasic Stimulator: Evaluation of Use During the Latarjet Procedure. Rimmke, Nathan A. MD; Jones, Grant L. MD; Bishop, Julie Y. MD Techniques in Orthopedics: June 2018 – Volume 33 – Issue 2 – p e5-e8.

  3. Intra-Operative Sciatic Nerve Assessment in Complex Total Hip Arthroplasty Using a Handheld Nerve Stimulator: A Case Series. Shai S Shemesh, MD, Samuel Overly, MD, Jonathan Robinson, MD, Catlin S. Mouchas, MD, Darwin Chen, MD Hip Int. 2018 Mar;28(2):210-217. doi: 10.5301/hipint.5000553. Epub 2017 Sep 10.

  4. Empowering the Surgeon – New neuroprotective and neuroreconstructive techniques. Michael R. Hausman, MD, Lippmann Professor of Orthopedic Surgery, Vice-Chairman, Department of Orthopedic Surgery, Chief, Hand and Elbow Surgery, Mount Sinai Medical Center.

  5. Nerve Repair Manual – A practical approach to injury and repair in the brachial plexus and upper extremity. Scott H. Kozin, MD, Chief of Staff, Shriners Hospital for Children – Philadelphia; Team Leader, Touching Hands Project, American Society for Surgery of the Hand.

*Dr. Hausman is a paid consultant of Checkpoint Surgical, Inc.