Factors Related to False-Versus True-Positive Neuromonitoring Changes in Adolescent Idiopathic Scoliosis Surgery

Noonan, Kenneth J.; Walker, Timothy J.; Feinberg, Judy R.; Nagel, Michelle; Didelot, William; Lindseth, Richard E.

doi:10.1097/00007632-200204150-00009

Cited by 80 publications

(43 citation statements)

References 27 publications

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“…30,38,45,47 No false negatives were observed and the number of false positives, true positives and true negatives is quite similar to those found in previous studies. [13][14][15]45 In agreement with other authors, [13][14][15]45,48 the persistence of MEPs and/or SEPs correctly predicted the motor or sensory postoperative outcome in our study cohort.…”

Section: Discussionsupporting

confidence: 92%

Somatosensory- and motor-evoked potential monitoring during spine and spinal cord surgery

et al. 2006

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Objectives: Complex spinal surgery carries a significant risk of neurological damage. The aim of this study is to determine the reliability and applicability of multimodality motor-evoked potentials (MEPs) and somatosensory-evoked potentials (SEPs) monitoring during spine and spinal cord surgery in our institute. Methods: Recordings of MEPs to multipulse transcranial electrical stimulation (TES) and cortical SEPs were made on 52 patients during spine and spinal cord surgery under propofol/ fentanyl anaesthesia, without neuromuscular blockade. Results: Combined MEPs and SEPs monitoring was successful in 38/52 patients (73.1%), whereas only MEPs from at least one of the target muscles were obtained in 12 patients (23.1%); both MEPs and SEPs were absent in two (3.8%). Significant intraoperative-evoked potential changes occurred in one or both modalities in five (10%) patients. Transitory changes were noted in two patients, whereas three had persistent changes, associated with new deficits or a worsening of the pre-existing neurological disabilities. When no postoperative changes in MEP or MEP/SEP modalities occurred, it was predictive of the absence of new motor deficits in all cases. Conclusion: Intraoperative combined SEP and MEP monitoring is a safe, reliable and sensitive method to detect and reduce intraoperative injury to the spinal cord. Therefore, the authors suggest that a combination of SEP/MEP techniques could be used routinely during complex spine and/or spinal cord surgery.Spinal Cord (2007) 45, 86-91.

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Section: Discussionsupporting

confidence: 92%

Somatosensory- and motor-evoked potential monitoring during spine and spinal cord surgery

et al. 2006

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“…In fact, mechanical injury, vascular injury or hypotensive anaesthesia can result in motor changes without concomitant sensory changes in neuromonitoring. The occurrence of transient SEP changes reverting to baseline before the end of surgery is also possible, correlating to postoperative neurologic deficits [16]. Many factors can affect the amplitude and latency of SEP waveforms during surgery [17].…”

Section: Discussionmentioning

confidence: 99%

The prevention of neural complications in the surgical treatment of scoliosis: the role of the neurophysiological intraoperative monitoring

et al. 2011

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“…The later developments of the neurophysiological methods clearly indicated that combined application of motor and sensory evoked potentials will increase the validity and reliability of the monitoring techniques and has been advocated by several studies [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…A question about the validity and the predictive accuracy of somatosensory evoked and motor evoked potentials were analysed by following 134 adolescent patients who underwent surgical correction of idiopathic scoliolis [6]. In this study no false negative readings were seen, however, six patients presented false positive findings.…”

Section: Introductionmentioning

confidence: 96%

Multimodal intraoperative monitoring during surgery of spinal deformities in 217 patients

et al. 2007

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A prospective study was performed on 217 patients who received MIOM during corrective surgery of spinal deformities between March 2000 and December 2005. Aim is to determine the sensitivity and specificity of MIOM techniques used to monitor spinal cord and nerve root function during corrective spine surgery. MIOM is becoming an increasingly used method of monitoring function during corrective spine surgery. The combination of monitoring of ascending and descending pathways may provide more sensitive and specific results giving immediate feedback information regarding any neurological deficits during the operation. Intraoperative somatosensory spinal and cerebral evoked potentials combined with continuous EMG and motor evoked potentials of the spinal cord and muscles were evaluated and compared with postoperative clinical neurological changes. A total of 217 consecutive patients with spinal deformities of different aetiologies were monitored by means of MIOM during the surgical procedure. Out of which 201 patients presented true negative findings while one patient presented false negative and three patients presented false positive findings. Twelve patients presented true positive findings where neurological deficit after the operation was predicted. All neurological deficits in those 12 patients recovered completely. The sensitivity of MIOM applied during surgery of spinal deformities has been calculated of 92.3% and the specificity 98.5%. Based upon the results of this study MIOM is an effective method of monitoring the spinal cord and nerve root function during corrective surgery of spinal deformities and consequently improves postoperative results. The Wake-up test for surgical procedure of spinal deformities became obsolete in our institution.

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Factors Related to False-Versus True-Positive Neuromonitoring Changes in Adolescent Idiopathic Scoliosis Surgery

Cited by 80 publications

References 27 publications

Somatosensory- and motor-evoked potential monitoring during spine and spinal cord surgery

Somatosensory- and motor-evoked potential monitoring during spine and spinal cord surgery

The prevention of neural complications in the surgical treatment of scoliosis: the role of the neurophysiological intraoperative monitoring

Multimodal intraoperative monitoring during surgery of spinal deformities in 217 patients

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