Neurosensory Testing:

Neurosensory testing is used by neurologists in order to provide a non-painful method to measure peripheral nerve function other than the traditional electrodiagnostic studies. The term neurosensory testing is typically not used to refer to nerve conductions studies or electromyography.  The term refers to the use of sensory tests, which are gradated and able to provide some level of quantified evaluation of sensibility.  Neurosensory testing is an extension of the physical examination and history.  It can be used to help identify nerve compression.  It can also help identify when nerves are recovering.  Most neurosensory testing is non-invasive and painless.  There are many ways which neurosensory testing can be performed.

More common methods of neurosensory evaluation include: static and moving 2-point discrimination, Semmes-Weinstein monofilament pressure testing, joint position assessment (kinesthesia), quantitative vibrometry and current perceptual threshold testing (CPT).  Detailed neurosensory testing can be used to perform sensory mapping of specific bodily regions. 

Neurosensory testing provides painless and cost efficient method of evaluating neurological recovery and for ruling out progressive nerve damage.  Neurosensory studies are often an important complement to more cursory and subjective sensory testing such as pinprick and pinwheel assessment performed during a routine examination.  Quantitative neurosensory testing can be used to help assess the therapeutic response.  There is an extensive amount of published normative data for the various forms of neurosensory evaluation.

Neurosonography:

Neurosonography is an imaging procedure that uses ultra high frequency sound waves enables a physician to analyze the integrity of neurological tissues.  Neurosonography may be used to evaluate and localize intrinsic spinal cord pathology during neurosurgery.  It provides the neurosurgeon with an opportunity to see inside the spinal cord and to precisely locate the problem area.  After removal of an abnormality (tumor, cyst, etc.) the neurosurgeon use neurosonography to check whether the operative procedure resulted in removal of all of the targeted tissue.

There are many diagnostic methods, which can be utilized to visualize the spine and spinal cord.  Ultrasound is portable, noninvasive and relatively inexpensive.  New generation ultrasound technology provides superior images.  Diagnostic ultrasonography offers full thickness tissue imaging.  There is no associated ionizing radiation and imaging can be obtained in multiple planes. 

The creation of a surgical window provides the attending spine surgeon an opportunity to use a sonar beam to help investigate the integrity of underlying spinal tissues.  Intra-operative spinal sonography (IOSS) can help direct the surgeon to the show this throughout the spinal lesion and a subsequently limiting the degree of tissue compromise.  Ultrasonography provides a method of intra-operative evaluation of spinal cord pathology specifically in the localization of tumors within the spinal cord abscess blood vessels malformations and cystic formations.