Monitoring Modalities

At RITON, we employ state-of-the-art instrumentation in order to monitor the nervous system and report any ongoing changes to the surgical team in real-time. The functional status of the nervous system is monitored using a combination of the following techniques:

SomatoSensory Evoked Potentials (SSEP): SSEPs from the upper and lower extremities allow recordings of sensory spinal cord integrity and spinal perfusion.  

Trans-Cranial Evoked Motor Potentials (TCeMEP): With the addition of the Transcranial Motor Monitoring (TCeMEPs) we can measure the motor integrity of the spinal cord for instantaneous changes that may occur during a case.

Electroencephalography (EEG): Electrical activity of the brain is recorded on all cases to ensure adequate cerebral perfusion, and as an indication of the level of anesthesia.

Electromyography (EMG): This electrical signal allows real-time muscle activity to indicate proximity and functional integrity of specific motor nerves.  The central and peripheral motor system can be assessed during such surgeries as spinal cases, spinal cases with pedicle screw placement, parotid and thyroid surgeries, along with vestibular schwannoma resections.

Brainstem Auditory Evoked Potentials (BAEP): are also used as a tool for monitoring electrical activity conducted by the auditory nerve and the brainstem pathways. This allows RITON to attempt hearing preservation during certain ENT procedures as well as brainstem protection during various neurosurgical cases.  Other Modalities: RITON is familiar with every modern monitoring modality utilized in surgery to date.  We can perform neurophysiological monitoring services in any medical facility in the country.