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Intraoperative Neurophysiological Monitoring for Spinal Cord Tumor Surgery: Comparison of Motor and Somatosensory Evoked Potentials According to Tumor Types

Authors
 Taeha Park  ;  Jinyoung Park  ;  Yoon Ghil Park  ;  Joowon Lee 
Citation
 Annals of Rehabilitation Medicine, Vol.41(4) : 610-620, 2017-08 
Journal Title
 Annals of Rehabilitation Medicine 
ISSN
 2234-0645 
Issue Date
2017-08
Keywords
Intraoperative neurophysiological monitoring ; Motor evoked potentials ; Postoperative complications ; Somatosensory evoked potentials ; Spinal cord neoplasm
Abstract
Objective: To identify which combination of motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) is most reliable for postoperative motor deterioration during spinal cord tumor surgery, according to anatomical and pathologic type. Methods: MEPs and SEPs were monitored in patients who underwent spinal cord tumor surgery between November 2012 and August 2016. Muscle strength was examined in all patients before surgery, within 48 hours postoperatively and 4 weeks later. We analyzed sensitivity, specificity, positive and negative predictive values of each significant change in SEPs and MEPs. Results: The overall sensitivity and specificity of SEPs or MEPs were 100% and 61.3%, respectively. The intraoperative MEP monitoring alone showed both higher sensitivity (67.9%) and specificity (83.2%) than SEP monitoring alone for postoperative motor deterioration. Two patients with persistent motor deterioration had significant changes only in SEPs. There are no significant differences in reliabilities between anatomical types, except with hemangioma, where SEPs were more specific than MEPs for postoperative motor deterioration. Both overall positive and negative predictive values of MEPs were higher than the predictive values of SEPs. However, the positive predictive value was higher by the dual monitoring of MEPs and SEPs, compared to MEPs alone. Conclusion: For spinal cord tumor surgery, combined MEP and SEP monitoring showed the highest sensitivity for the postoperative motor deterioration. Although MEPs are more specific than SEPs in most types of spinal cord tumor surgery, SEPs should still be monitored, especially in hemangioma surgery.
Files in This Item:
T201706190.pdf Download
DOI
10.5535/arm.2017.41.4.610
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
Park, Jinyoung(박진영) ORCID logo https://orcid.org/0000-0003-4042-9779
Park, Tae Ha(박태하)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/178305
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