The patient is placed prone with the head straight and secured in a Mayfield head holder. Neurophysiological monitoring (NIM-Neuro and NIM-Eclipse, Medtronic) and neuronavigation (StealthStation S7, Medtronic; or Brainlab Cranial 3.0) are set up. According to tumor extension, LCNs, cranial nerves VI and VII, and motor evoked potentials were monitored. The choice of the surgical side is made according to the most extensive condyle involvement, the largest lateral extension, and VA involvement.
Nim eclipse
Manufactured by Medtronic
Sourced in United States
The NIM-Eclipse is a nerve monitoring system designed to assist surgeons during procedures. It provides real-time feedback on the location and function of nerves near the surgical site. The system includes a handheld nerve stimulator, disposable electrodes, and software to display and record nerve signals.
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Lab products found in correlation
8 protocols using nim eclipse
1
Prone Skull Base Surgery Monitoring
2
Evaluating Motor Cortex Stimulation in SCI
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D‐waves were recorded before and 10 min after SCI.46 To stimulate the motor cortex, two 5 cm small skin incisions were placed in the scalp overlaying the skull. Two stimulation trains of stimulus intensities of 50–400 V (pulse duration 1.0 ms, ISI 0.5 ms) were delivered through stainless steel alligator clips clamped to the screws, which were placed according to the international 10–20 nomenclature: FC1, FC2 was assigned to points 7.5 mm towards the nasion from the vertex and 5 mm lateral to the midline. Two double contact strip electrodes (Cortac Electrodes, PMT Corporation) were placed in the exposed dura at dorsal epidural space 1 cm cranial and 1 cm caudal to the injury site. D waves were recorded by stimulating the motor cortex before and after the spinal cord contusion injury. All the signals recorded were amplified and filtered (50.0 Hz low frequency, 1 kHz high frequency, Nim Eclipse, Medtronic, MN, USA). Amplitude and latencies were recorded before and after the SCI from above and below the injury site. After recording the data, the holes were filled with bone wax and the incision was closed using absorbable continuous subcuticular suture.
3
Minimally Invasive Spinal Fusion Techniques
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Direct lateral interbody fusion (DLIF; Medtronic Sofamor Danek, Inc. Memphis, TN, USA) and Extreme lateral interbody fusion (XLIF; NuVasive, Inc., San Diego, California) side path minimally invasive fusion system are both used in side channel minimally invasive channel. Intraoperative neurological monitoring of patients was performed using the NIM-Eclipse (Medtronic, Medtronic Inc., Jacksonville, FL).
4
Surgical Techniques for Cerebral Aneurysms
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Surgeries were performed under general anesthesia. All routine operations were performed using intraoperative neuromonitoring (NIM-Eclipse; Medtronic, FL, USA). A surgical navigation system (Curve® Navigation, Brainlab, Germany) was used when necessary. The trans-sylvian approach involves Sylvian fissure dissection, followed by access to the aneurysm. The trans-sulcal approach involves opening the sulcus starting from the distal branch of the distal MCA aneurysm. Surgical techniques for the treatment of cerebral aneurysms can be classified as neck clipping, wrap clipping, proximal occlusion, trapping, and additional bypass, if necessary. The use of a surgical navigation system during the procedure can also be considered as a separate category.
5
Electrophysiological Muscle Response Recording
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Electrophysiological recordings were conducted using the NIM Eclipse monitoring and stimulation system (Medtronic Xomed Inc, Jacksonville, FL, USA). Single-pulses of EES (0.5 Hz) were delivered at increasing amplitude to elicit muscle responses that were recorded from subdermal (Neuroline Twisted Pair Subdermal, 12 x 0.4 mm, Ambu A/S, Ballerup, Denmark) or intramuscular needle electrodes (Ultra Sharp, 44 mm/27 g, Chalgren Enterprises, Inc. Gilroy, CA, USA).
6
Intraoperative neuromonitoring during spinal surgery
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Motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) were studied using the Medtronic NIM-eclipse® 32-channel system. IONMs were recorded during the whole procedure from patient positioning to laminoplasty and wound closure. Our anesthesiologic plan includes a standard value of mean arterial pressure above 80 mmHg, in order to ensure adequate blood supply to the spinal cord during the surgical procedure. In case of changes in IONM data the first due check is related to any changes in anesthesiologic plan: every administration of curare or anesthetic gas requires an adequate disposal period. We usually acquire IONM data before and after pronating the patients, in order to identify any changes and eventually adjust the position. All the patients underwent laminotomy and subsequent laminoplasty, sparing the articular joints in order to preserve the spinal stability and avoid instrumentation. The procedures were performed by four surgeons of the same team. IONM changes can occur during surgical dissection (Figure 1 ); in these cases, the surgeon usually proceeds to irrigate with saline solution, modify the surgical strategy and, in some cases, systemically administer steroids. We have a specific protocol about intraoperative MAPs.
7
Multimodal Intraoperative Neurophysiological Monitoring
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IONM included triggered CN electromyography, brainstem auditory evoked potentials (BAEPs), and disappearance of the lateral spread response (LSR). IONM was performed by using the NIM-Eclipse (Medtronic, Minneapolis, MN, USA) system.
8
Comprehensive Intraoperative Neuromonitoring Protocol
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The intraoperative neuromonitoring (IONM) plan for each patient included free-run and triggered cranial nerve electromyography, brainstem auditory evoked potentials (BAEPs), and lateral spread response (LSR) monitoring. IONM was performed using a Cascade (Cadwell) or NIM-Eclipse (Medtronic) system. Electromyography activity was recorded from needle electrodes inserted intradermally in the frontalis, orbicularis oculi, orbicularis oris, and mentalis muscles. LSR was evoked by stimulation of the zygomatic branch of the ipsilateral facial nerve from 6 to 12 mA. LSRs were recorded from the ipsilateral orbicularis oris and mentalis muscles. Short-acting depolarizing muscle relaxants were administered at induction and then maintained at minimal doses to preserve signals from the ulnar nerve, the median nerve, and the posterior tibial nerve. For BAEPs, alternating rarefaction and condensation clicks were delivered individually to each ear at 85-to 95-dB-SPL intensity at a rate of 11.1-17.5 Hz. While one ear was being stimulated, contralateral white noise masking 40-65 dB-SPL was applied. BAEPs were recorded via subdermal needles placed at A1, A2, and CPz with channels of A1-CPz and A2-CPz for the left and right ears, respectively. All BAEPs were bandpass filtered from 100 to 1000 Hz, and 200-500 trials were used for BAEP recording.
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