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NASS Posts IONM Podcast Episode 2 - "Can't Anyone Monitor The Case?"

Posted By Richard W. Vogel, Thursday, March 7, 2019

Be sure to check out the new neuromonitoring podcast from the North American Spine Society (NASS), developed by ASNM members who Chair the NASS Section on Intraoperative Neurophysiological Monitoring. 

 

In each of the 12 Episodes this season, Section Co-Chairs Drs. Adam Doan and Rich Vogel will discuss "How to Optimize Neuromonitoring". 

 

In Episode 2, they address the question, "Can't anyone cover the case?" 

 

"Did you know IONM is learned through on-the-job training, licensure does not exist, and certifications are not required for the technologist in your OR? After initial training, technologists can monitor very basic cases (e.g., PLIF), but they should spend years in training to learn more complex procedures (deformity, tumors). If a surgery isn’t booked accurately, the surgeon might get a very junior person assigned to a very complex case. Here we inform the listener of common practices around determining “competency” for performing IONM in spine surgery."

 

Disclaimer: The views, thoughts, and opinions expressed in this blog post  are solely those of the author(s). Blog posts do not represent the thoughts, intentions, strategies or policies of the author’s employer or any organization, committee or other group or individual, including the ASNM. The ASNM, along with the author(s) of this post, makes no representations as to the completeness, accuracy, suitability, validity, usefulness or timeliness of any information in this blog and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use. All information is provided on an as-is basis. Any action you may take based upon the information on this website is strictly at your own risk.

Tags:  Announcement  Podcast 

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Neuromonitoring Podcast from NASS

Posted By Richard W. Vogel, Tuesday, January 15, 2019

ASNM Members Launch Neuromonitoring Podcast Through NASS:

The ASNM is happy to annouce the new neuromonitoring podcast from the North American Spine Society, developed by ASNM members who Chair the NASS Section on Intraoperative Neurophysiological Monitoring.

In each of the 12 Episodes this season, Section Co-Chairs Drs. Adam Doan and Rich Vogel will discuss "How to Optimize Neuromonitoring".

In Episode 1, they address the question, "What information is critical to communicate to the neuromonitoring team in advance of surgery, and how far in advance?"

 

Disclaimer: The views, thoughts, and opinions expressed in this blog post  are solely those of the author(s). Blog posts do not represent the thoughts, intentions, strategies or policies of the author’s employer or any organization, committee or other group or individual, including the ASNM. The ASNM, along with the author(s) of this post, makes no representations as to the completeness, accuracy, suitability, validity, usefulness or timeliness of any information in this blog and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use. All information is provided on an as-is basis. Any action you may take based upon the information on this website is strictly at your own risk.

Tags:  Announcement 

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ASNM Members Participate in Ask The Experts Video

Posted By Richard W. Vogel, Tuesday, December 4, 2018

As we mentioned in a recent post, NASS has a topical video series called Ask the Experts in which experts in various fields go on camera to discuss a specific topic. At this meeting, Drs. Vogel, Doan and Sestokas went on camera to tackle the question, What are the real criteria for a neuromonitoring alert in spine surgery?

Surgeons may think pedicle screw thresholds below 10 mA are an alert, or apply the old 50%/10% rule for SSEPs, or use presence/absence for MEPs, but all of examples are wrong for one reason or another. The experts stressed the importance of precision medicine, treating each patient as an individual, and considering data changes in the context of various factors. In this video, Dr. Vogel served as a moderator and posed a series of questions to Drs. Doan and Sestokas. 

Enjoy:

 

Disclaimer:

The views, thoughts, and opinions expressed in this blog post are solely those of the author(s). Blog posts do not represent the thoughts, intentions, strategies or policies of the author’s employer or any organization, committee or other group or individual, including the ASNM. The ASNM, along with the author(s) of this post, makes no representations as to the completeness, accuracy, suitability, validity, usefulness or timeliness of any information in this blog and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use. All information is provided on an as-is basis. Any action you may take based upon the information on this website is strictly at your own risk.

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Neuromonitoring at NASS

Posted By Richard W. Vogel, Monday, November 19, 2018

ASNM Members Formally Represent Neuromonitoring at NASS:

The North American Spine Society (NASS) is a global, multidisciplinary medical society that utilizes education, research and advocacy to foster the highest quality, ethical, value- and evidence-based spine care for patients. Many people think that NASS is a “spine surgeon society”, but that’s not exactly true. Members actually come from a wide variety of backgrounds, including neuromonitoring, and a common interest in “spine” is the tie that binds all NASS members.

In 2017, after 40 years of working in spine surgery, neuromonitoring had no representation within NASS. That all changed in 2018, thanks to the leadership of ASNM members Dr. Rich Vogel (President -Elect) and Dr. Adam Doan (member, Representation and Advocacy Committee). Drs. Vogel and Doan submitted an application to NASS (later approved) to form a Section on Intraoperative Neurophysiological Monitoring (IONM). A “Section” is like a Committee, but with a more specific focus. NASS’s mission to advance global spine care is accomplished, at least in part, through the collective works of its Councils, Committees and Sections.

As Co-Founders and Co-Chairs of the new Section on IONM, Drs. Vogel and Doan are now part of NASS’s leadership, representing the neuromonitoring community and helping to advance global spine care. Many of the founding members of the NASS Section on IONM are also members of the ASNM, including: Dr. Robert Holdefer, Dr. Nancy Mirarchi, Dr. John Ney (ASNM Board) and Dr. Anthony Sestokas. Other founding members include Dr. David van der Goes (health economist) and Dr. Todd Wetzel (spine surgeon and neuromonitoring advocate). This group has been very successful in their first year as a Section representing IONM in NASS.

NASS 2018 Annual Meeting:

The 33rd Annual Meeting of NASS was held Sep 24 - 29, 2018 in Los Angeles, Ca. At this meeting the Section on Intraoperative Neurophysiological Monitoring took part in the following events:

Neuromonitoring Symposium:

Drs. Vogel and Doan hosted NASS’s first symposium devoted specifically to IONM, which was planned entirely by the Section’s founding members. The Symposium was entitled, Analyzing the Utility, Evidence & Value of Neuromonitoring in Spine Surgery. Drs. Vogel and Doan served as moderators, introducing speakers and keeping the agenda running on time. Here are the lectures the we planned and the speakers we invited:

  • Point-Counterpoint: On the Utility of Neuromonitoring in Spine Surgery
    • Joshua E. Heller, MD and Steven M. Theiss, MD
  • What Represents Good Study Design and Good Evidence in Neuromonitoring and Why?
    • Robert N. Holdefer, PhD
  • Cost-Effectiveness Modeling and Surgical Risk in Neuromonitoring
    • John P. Ney, MD, MPH and David N. van der Goes, PhD
  • Barriers to Quality and Safety in the Performance of Neuromonitoring
    • Richard Vogel, PhD
  • Neuromonitoring and Precision Medicine: The Problem of Heterogeneity
    • Anthony K. Sestokas, PhD
  • International Speaker IONM Experience
    • Abdul Karim Msaddi, MD (Dubai, UAE)

At the end of the day, this Symposium was a great success. We went 45 overtime with Q&A from the audience. We’re already in the beginning stages of planning the next Symposium for the 2019 meeting.

Abstract Session:

Drs. Vogel and Doan also had the opportunity to moderate an abstract session. The topic was chosen by NASS based on research abstracts submitted to the meeting. This particular abstract session was entitled, Navigation and Intraoperative Neuromonitoring. Once again, Drs. Vogel and Doan served as moderators, introducing speakers and keeping the agenda running on time. They also had the opportunity to choose a “best abstract” and award the presenting author with a certificate.

The best abstract in this session was: A Novel MRI-Based Classification of Spinal Cord Shape and CSF Presence at the Curve Apex to Assess Risk of Intraoperative Neuromonitoring Data Loss with Thoracic Spinal Deformity Correction by Drs. Sielatycki, Makhni, Lehman and Lenke from Columbia University/NY Presbyterian.

The authors used a novel, MRI-based spinal cord risk classification scheme (Type 1, 2, or 3) to identify patients at risk of losing monitoring data during surgery. Results demonstrated patients with a spinal cord deformed against the apical concave pedicle (Type 3) had 28 times greater odds of losing monitoring data during surgery vs. Type 1 (normal cord with adequate CSF) and Type 2 (normal cord without CSF between cord and concave pedicle).

Ask the Experts:

NASS has a topical video series called As the Experts in which experts in various fields go on camera to discuss a specific topic. At this meeting, Drs. Vogel, Doan and Sestokas went on camera to tackle the question, What are the real criteria for a neuromonitoring alert in spine surgery?

Surgeons may think pedicle screw thresholds below 10 mA are an alert, or apply the old 50%/10% rule for SSEPs, or use presence/absence for MEPs, but all of examples are wrong for one reason or another. The experts stressed the importance of precision medicine, treating each patient as an individual, and considering data changes in the context of various factors. In this video, Dr. Vogel served as a moderator and posed a series of questions to Drs. Doan and Sestokas. We hope the video will ultimately be made publicly available for all to see.

Dr. W. Bryan Wilent Won a Best Paper Award:

The NASS 2018 Scientific Program Committee received an overwhelming 1,200 abstract submissions, but only the 21 highest-rated abstracts earned the coveted “Best Paper” designation. This year, two neuromonitoring abstracts were named best paper, and one was authored by ASNM Board Member and Research Committee Chair Dr. Bryan Wilent.

This Best Paper abstract was entitled: Diagnostic Accuracy And Clinical Impact Of Motor Evoked Potential (MEP) Monitoring During 4425 Posterior Extradural Lumbosacral Procedures Involving The L5 Vertebra.

Dr. Wilent’s study is the largest of many recently-published studies demonstrating the utility of MEPs in lumbar spine surgery.

Looking to 2019:

The IONM Section is already at work developing proposals for the 2019 NASS Annual Meeting, which will be held in Chicago September 25-28. You can support these endeavors by joining NASS and/or submitting your research when abstract submission open in 2019. For more information, contact Rich Vogel.

 

Disclaimer: The views, thoughts, and opinions expressed in this blog post  are solely those of the author(s). Blog posts do not represent the thoughts, intentions, strategies or policies of the author’s employer or any organization, committee or other group or individual, including the ASNM. The ASNM, along with the author(s) of this post, makes no representations as to the completeness, accuracy, suitability, validity, usefulness or timeliness of any information in this blog and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use. All information is provided on an as-is basis. Any action you may take based upon the information on this website is strictly at your own risk.

Tags:  Announcement 

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Board Update - Committee Repopulation

Posted By Administration, Tuesday, May 15, 2018

Update from the ASNM Board of Directors:

At our last Board Meeting, it came to our attention that each of our 8 standing committees has dozens (if not hundreds) of members, many of whom don’t even know they’re on a committee. How did this happen? It turns out that the process for joining a committee was simply to click a button expressing interest during the initial ASNM membership application. Many people expressed interests in multiple committees. So, some of you may belong to multiple committees and probably don’t even know it.

In seeking to make our committees more efficient and effective as they manage their work and meet the overall mission of the Society, we realize that we need to do some repopulating. The committees and their functions will remain the same as outlined in our bylaws, but we need to start fresh with committee membership.

Here’s the process for committee repopulation and how you can get/remain involved:

  1. The glitch that allowed people to automatically join committees during initial membership application has already been fixed.
  2. We will poll each Committee Chair to determine who are the core, active members of each committee. These individuals will be contacted and given the opportunity to remain part of the committee. If the individuals are members of multiple committees, they may be asked to make a choice and focus their efforts on one committee.
  3. All “extra” committee members (i.e., those who aren’t presently participating) will be removed from all committees so we can start fresh.
  4. Each committee will meet to determine how many members they need to accomplish their work. Where there is need, openings will be made for ASNM members to fill.
  5. We will send out an email to all ASNM members asking if you are interested in committee participation. That email will give you instructions on how to join a committee if space is available.

Remember that committee work is voluntary. When considering committee participation, think about how much time and energy is required and whether or not you are able to dedicate that time and energy. It is best if you participate in only one committee so you don’t stretch yourself too thin.

Being part of a committee is definitely not just about putting something new on your resume or CV. This should be service to the profession that produces meaningful results and introduces members to networking opportunities. Everyone on a committee will be expected to participate in meetings and pull their weight to accomplish the committee’s work. Anyone who isn’t doing their part may be removed from the committee to make room for someone else.

How can you get involved? You don’t have to do anything right now. We’ll contact you in a few weeks to gauge your interest. Until then, check out the names of the different committees and the kinds of work they do. Think about where your interests lie, and what you’d like to see the ASNM accomplish. Your voice matters, and the best way to make a change is to jump in and help!

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ASNM Releases Position Statement on Business Practices in Neuromonitoring

Posted By Administration, Wednesday, March 14, 2018

Breaking News!

 In a newly-released Position Statement, the ASNM takes a stand on business practices related to neuromonitoring.

Read the entire position statement here.

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2018 ASNM Election Results

Posted By Administration, Tuesday, November 14, 2017
Updated: Tuesday, November 14, 2017

ASNM is pleased to report the results of the 2018 Election:

Rich Vogel has been chosen as President-Elect.

The new Directors are:

Megan Alcauskas
George Grudziak
John Ney
Christopher Pace

Changes will take effect on May 1, 2018.

You can read about all of the candidates here

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Utilizing our New Website with Member Network and Blog

Posted By Administrator, Monday, November 13, 2017
Updated: Wednesday, August 30, 2017

Utilizing the new ASNM Website:

Website features:

  • Contemporary look with new ASNM logo
  • Responsive design
  • Efficient menu system
  • Blog
  • Member networking community

Design:

Our new website is compatible on any device. The menu system has been reorganized to facilitate navigation and help you find information quickly.

The Blog:

If you’ve been a member of ASNM for a while, you probably remember our monthly newsletter, The Monitor, which was distributed via email and archived on our website in pdf format. In an effort to enhance communication with our membership and keep you in the know, we decided to roll the newsletter into a blog where we could post articles and updates as frequently as possible. Each post will be tagged, archived and easily searchable. The content will be similar to what we published in our previous newsletter.

Member Community:

We launched a new community on the ASNM website called SocialLink. A brand-new way to easily connect with fellow colleagues, share information across the ASNM network and manage your membership preferences.

Finding member information and updates are easier than ever thanks to this exciting new enhancement.

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