{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:46:38Z","timestamp":1786124798481,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2020,7,25]],"date-time":"2020-07-25T00:00:00Z","timestamp":1595635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Percutaneous ablation of the cervical spinothalamic tract (STT) remains a therapeutic remedy for intractable cancer pain. However, it is accompanied by the risk of collateral damage to essential spinal cord circuitry, including the corticospinal tract (CST). Recent studies describe threshold-based mapping of the CST with the objective of motor bundle preservation during intramedullary spinal cord and supratentorial surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To assess the possibility that application of spinal cord mapping using intraoperative neuromonitoring in percutaneous cordotomy procedures may aid in minimizing iatrogenic motor tract injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We retrospectively reviewed the files of 11 patients who underwent percutaneous cervical cordotomy for intractable oncological pain. We performed quantitative electromyogram (EMG) recordings to stimulation of the ablation needle prior to the STT-ablative stage. We compared evoked motor and sensory electrical thresholds, and the electrical span between them as a reliable method to confirm safe electrode location inside the STT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Quantified EMG data were collected in 11 patients suffering from intractable cancer pain. The threshold range for evoking motor activity was 0.3 to 1.2 V. Stimulation artifacts were detected from trapezius muscles even at the lowest stimulation intensity, while thenar muscles were found to be maximally sensitive and specific. The minimal stimulation intensity difference between the motor and the sensory threshold, set as \u201c\u0394-threshold,\u201d was 0.26 V, with no new motor deficit at 3 days or 1 month postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Selective STT ablation is an effective procedure for treating intractable pain. It can be aided by quantitative evoked EMG recordings, with tailored parameters and thresholds.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opaa209","type":"journal-article","created":{"date-parts":[[2020,7,25]],"date-time":"2020-07-25T11:46:53Z","timestamp":1595677613000},"page":"E566-E572","source":"Crossref","is-referenced-by-count":7,"title":["Intraoperative Neurophysiology for Optimization of Percutaneous Spinothalamic Cordotomy for Intractable Cancer Pain"],"prefix":"10.1227","volume":"19","author":[{"given":"Yechiam","family":"Sapir","sequence":"first","affiliation":[{"name":"Surgical Monitoring Services, Beit Shemesh, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiva","family":"Korn","sequence":"additional","affiliation":[{"name":"Surgical Monitoring Services, Beit Shemesh, Israel"},{"name":"Intraoperative Neurophysiological Monitoring Service, Tel Aviv Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifat","family":"Bitan-Talmor","sequence":"additional","affiliation":[{"name":"Surgical Monitoring Services, Beit Shemesh, Israel"},{"name":"Intraoperative Neurophysiological Monitoring Service, Tel Aviv Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Vendrov","sequence":"additional","affiliation":[{"name":"Intraoperative Neurophysiological Monitoring Service, Tel Aviv Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assaf","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Shofty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Zegerman","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"Division of Anesthesia and Critical Care, Tel Aviv Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ido","family":"Strauss","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,12]]},"reference":[{"issue":"5","key":"bib1-20231106","first-page":"1","article-title":"Surgical\/radiological interventions for cancer pain","volume":"17","author":"Harsh","year":"2014","journal-title":"Curr Pain Headache Rep"},{"issue":"1","key":"bib2-20231106","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3171\/2010.6.JNS10119","article-title":"Destructive procedures for control of cancer pain: the case for cordotomy","volume":"114","author":"Raslan","year":"2011","journal-title":"J Neurosurg"},{"issue":"3 Suppl.","key":"bib3-20231106","first-page":"187","article-title":"Computed tomography-guided percutaneous cordotomy for intractable pain in malignancy","volume":"64","author":"Kanpolat","year":"2009","journal-title":"Neurosurgery"},{"issue":"6","key":"bib4-20231106","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1159\/000484614","article-title":"O-Arm-guided percutaneous radiofrequency cordotomy","volume":"95","author":"Strauss","year":"2017","journal-title":"Stereotact Funct Neurosurg"},{"issue":"3 Suppl 1","key":"bib5-20231106","first-page":"226","article-title":"Percutaneous computed tomography-guided radiofrequency ablation of upper spinal cord pain pathways for cancer-related pain","volume":"62","author":"Raslan","year":"2008","journal-title":"Neurosurgery"},{"issue":"1","key":"bib6-20231106","first-page":"133","article-title":"CT-guided high-level percutaneous cervical cordotomy for intractable cancer pain","volume":"27","author":"Bekar","year":"2017","journal-title":"Turk Neurosurg"},{"issue":"2","key":"bib7-20231106","doi-asserted-by":"crossref","first-page":"205","DOI":"10.3171\/2014.10.SPINE1474","article-title":"High-resolution direct microstimulation mapping of spinal cord motor pathways during resection of an intramedullary tumor","volume":"22","author":"Gandhi","year":"2015","journal-title":"J Neurosurg Spine"},{"issue":"2","key":"bib8-20231106","doi-asserted-by":"crossref","first-page":"161","DOI":"10.3171\/2016.12.SPINE16985","article-title":"Continuous mapping of the corticospinal tracts in intramedullary spinal cord tumor surgery using an electrified ultrasonic aspirator","volume":"27","author":"Barzilai","year":"2017","journal-title":"J Neurosurg Spine"},{"key":"bib10-20231106","first-page":"469","author":"Liu","year":"2002","journal-title":"Journal of Neurology, Neurosurgery & Psychiatry."},{"issue":"1","key":"bib11-20231106","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.clinph.2013.06.187","article-title":"Determination of motor threshold using visual observation overestimates transcranial magnetic stimulation dosage: safety implications","volume":"125","author":"Westin","year":"2014","journal-title":"Clin Neurophysiol"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/19\/6\/E566\/39708408\/opaa209.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opaa209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:45:47Z","timestamp":1786121147000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opaa209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,25]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opaa209","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,25]]}}}