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Monitoring of Motor and Somatosensory Evoked Potentials During Spine Surgery: Intraoperative Changes and Postoperative Outcomes

Authors
 Shin Hye Chang  ;  Yoon Ghil Park  ;  Dae Hyun Kim  ;  Seo Yeon Yoon 
Citation
 Annals of Rehabilitation Medicine, Vol.40(3) : 470-480, 2016 
Journal Title
 Annals of Rehabilitation Medicine 
ISSN
 2234-0645 
Issue Date
2016
Keywords
Intraoperative neurophysiological monitoring ; Motor evoked potentials ; Somatosensory evoked potentials ; Spine
Abstract
OBJECTIVE: To evaluate whether the combination of muscle motor evoked potentials (mMEPs) and somatosensory evoked potentials (SEPs) measured during spinal surgery can predict immediate and permanent postoperative motor deficits. METHODS: mMEP and SEP was monitored in patients undergoing spinal surgery between November 2012 and July 2014. mMEPs were elicited by a train of transcranial electrical stimulation over the motor cortex and recorded from the upper/lower limbs. SEPs were recorded by stimulating the tibial and median nerves. RESULTS: Combined mMEP/SEP recording was successfully achieved in 190 operations. In 117 of these, mMEPs and SEPs were stable and 73 showed significant changes. In 20 cases, motor deficits in the first 48 postoperative hours were observed and 6 patients manifested permanent neurological deficits. The two potentials were monitored in a number of spinal surgeries. For surgery on spinal deformities, the sensitivity and specificity of combined mMEP/SEP monitoring were 100% and 92.4%, respectively. In the case of spinal cord tumor surgeries, sensitivity was only 50% but SEP changes were observed preceding permanent motor deficits in some cases. CONCLUSION: Intraoperative monitoring is a useful tool in spinal surgery. For spinal deformity surgery, combined mMEP/SEP monitoring showed high sensitivity and specificity; in spinal tumor surgery, only SEP changes predicted permanent motor deficits. Therefore, mMEP, SEP, and joint monitoring may all be appropriate and beneficial for the intraoperative monitoring of spinal surgery.
Files in This Item:
T201604278.pdf Download
DOI
10.5535/arm.2016.40.3.470
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Park, Yoon Ghil(박윤길) ORCID logo https://orcid.org/0000-0001-9054-5300
Yoon, Seo Yeon(윤서연)
Chang, Shin Hye(장신혜)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152345
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