Prognostic value Analysis of Intraoperative Transcranial Electrical Stimulation motor evoked Potential Monitoring in Postoperative limb Function changes of Neurosurgical Patient

Abstract

Objective: To explore the predictive value of intraoperative transcranial electrical stimulation motor evoked potential (TES-MEP) monitoring for postoperative muscle strength change in patients undergoing craniocerebral surgery. Methods: In this study, 166 patients who underwent intraoperative motor evoked potential (MEP) monitoring were retrospectively analyzed. Univariate analysis and binary Logistic regression were used to analyze the influencing factors of postoperative muscle strength changes. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of abnormal changes of MEP amplitude in postoperative muscle strength changes. Results: Binary Logistic regression analysis showed that the abnormal amplitude of MEP during operation was an independent risk factor for short-term and long-term muscle strength decline after operation (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) for abnormal changes of MEP amplitude to predict short-term postoperative muscle strength decline was 0.754, with a sensitivity of 0.516, with a specificity of 0.993, and the AUC for long-term postoperative was 0.782, with a sensitivity of 0.591 and specificity of 0.972. Conclusions: The decrease of MEP amplitude more than 50% as a warning standard has a good predictive value for the change of limb function after operation, and the abnormal changes of MEP amplitude indicate that the muscle strength of patients after operation may be lower than that before operation.