The Neurodiagnostic journal
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This case illustrates the benefits of utilizing intraoperative neurophysiological monitoring (IONM) for preventing injury to sensory/motor pathways of the spinal cord during a cordotomy procedure to relieve pain. Cordotomy has been used effectively in the treatment of visceral pain but comes with a high risk of damaging motor and sensory pathways due to close proximity of lesion. The subject is a 47-year-old female with a pancoast tumor of the left lung, left brachialplexopathy, and severe neuropathic pain syndrome, refractory to medical therapy. ⋯ The surgeon decided to stop the cordotomy at that point. Postoperatively, the patient had no sensory or motor deficit. In this patient, TCeMEPs were used effectively to guide the surgeon in preventing damage to the spinal cord that could lead to motor deficits.