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Srdjan Mirkovic, M.D.

Srdjan Mirkovic, M.D.

Srdjan Mirkovic, M.D.

Spine Surgery, Disc Herniations, Spinal Stenosis
  • Locations
    Locations
    A

    NOI NorthShore Orthopedics Chicago

    680 N Lake Shore Dr
    Ste 924
    Chicago, IL 60611
    847.664.6848 866.954.5787 fax Get Directions This location is wheelchair accessible.
    B

    NorthShore Medical Group

    2180 Pfingsten Rd.
    Suite 3100
    Glenview, IL 60026
    847.866.7846 866.954.5787 fax Get Directions This location is wheelchair accessible.
  • Publications
    Publications
    • Alternative anterior reference sites for measuring posterior tibial nerve somatosensory evoked potentials.

      Journal of clinical monitoring and computing 2010 Apr

      Authors: Bebawy JF, Gupta DK, Cotton MA, Gil KS, Fohrman EB, Mirkovic S, Koht A
      Abstract
      The purpose of this study was to examine the utility and feasibility of using alternative anterior reference leads when measuring left posterior tibial nerve somatosensory evoked potentials (SEPs).
      With IRB approval, 12 patients were monitored using both traditional (FPz and C4') and alternative anterior (F3 and F4) reference leads during routine spine surgery with SEP monitoring. Recordings from the routine and novel electrode pairs were collected and analyzed.
      All of the SEP amplitudes measured were of similar magnitude except for that of F3-F4, which was significantly lower (P < 0.001) than all of the other five lead combinations which were assessed (Cz'-FPz, C3'-C4', C3'-F4, Cz'-F3, and Cz'-F4). The latencies of the novel lead combinations (C3'-F4, Cz'-F3, Cz'-F4, and F3-F4) were similar to those of the "gold standards" (Cz'-FPz and C3'-C4') (pooled median, 45.6 ms with 25-75th percentiles, 44.0-47.8 ms, P = 0.308). The coefficients of variation (CV %) of the amplitudes were not statistically significantly different (P = 0.341).
      The use of alternative frontal reference leads (F3 and F4) for left posterior tibial nerve SEP monitoring yields signals of equal quality and reproducibility compared to signals with standard (FPz and C4') referencing. These alternative leads may substitute for traditional referencing when placement of FPz or C4' is precluded by the location of surgery.
      PMID: 20063048 [PubMed - as supplied by publisher]
    • Biomechanical comparison of a novel percutaneous transfacet device and a traditional posterior system for single level fusion.

      Journal of spinal disorders & techniques 2006 Dec

      Authors: Mahar A, Kim C, Oka R, Odell T, Perry A, Mirkovic S, Garfin S
      Abstract
      Posterior spinal fusions are indicated for a variety of spinal disorders. Transfacet fixation minimizes soft tissue disruption and preserves the adjacent facet joint. This technique is uncommon due to concerns with biomechanical stability and proper implant placement. For these reasons, a length adjustable implant may obviate the clinical concerns but necessitates biomechanical study. This study evaluated the in vitro biomechanical stability between a novel transfacet fixation device compared with standard pedicle screws during cyclic physiologic loading in a human cadaveric model. Cadaveric L4-L5 lumbar motion segments from 16 human spines were tested in cyclic flexion/extension, lateral bending, and torsion after insertion of either transfacet fixation devices or 5.5 mm pedicle screw instrumentation. A load cell was used to measure the compressive forces on the anterior column during testing. Motion segment stiffness and anterior column compression were analyzed with a 1-way analysis of variance (P<0.05). The transfacet device demonstrated a statistically similar stiffness when compared with the pedicle screw system for each test direction. For anterior column loading during physiologic testing, there were no biomechanical differences between stabilization systems. Percutaneous transfacet fixation is an attractive surgical option for single-level spinal fusions. A biomechanical evaluation of a novel device for this application demonstrated similar stability to a pedicle screw system. The length adjustability of the device may alleviate concerns for precise device placement and the biomechanical stability may produce similar rates and quality of posterior spinal fusions.
      PMID: 17146303 [PubMed - as supplied by publisher]
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