Value of Dermatomal Somatosensory Evoked Potentials in Detecting Acute Nerve Root Injury

Tsai, Tse-Min; Tsai, Ching-Lin; Lin, Te-Sheng; Lin, Chou-Ching K.; Jou, I‐Ming

doi:10.1097/01.brs.0000179311.87137.0d

Cited by 22 publications

(6 citation statements)

References 30 publications

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“…Tsai et al18) tried to detect nerve root injuries using a DSEP study in rats, and he reported that the sensitivity and specificity of the DSEP study was higher with submaximal stimulation intensity than with supramaximal stimulation intensity.. In our previous study13), we also reported that the diagnostic sensitivity of DSEP in lumbar radiculopathy patients could be enhanced by lowering the intensity of electrical stimulation as compared with the conventional intensity.…”

Section: Discussionmentioning

confidence: 70%

Changes in Dermatomal Somatosensory Evoked Potentials according to Stimulation Intensity and Severity of Carpal Tunnel Syndrome

Sohn

Seo

Min

et al. 2012

J Korean Neurosurg Soc

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ObjectiveTo investigate the change of latency of cervical dermatomal somatosensory evoked potential (DSEP) according to stimulation intensity (SI) and severity of carpal tunnel syndrome (CTS).MethodsStimulation sites were the C6, C7, and C8 dermatomal areas. Two stimulation intensities 1.5×sensory threshold (ST) and 2.5×ST were used on both normal and CTS patients.ResultsIn moderate CTS, the latencies of C6 and C7 DSEP during 1.5×ST SI and those of C7 DSEP during 2.5×ST SI were significantly delayed compared with the values of normal subjects. Significant correlation between the latency of C7 DSEP of 2.5×ST stimulation and the median sensory nerve conduction velocity was observed.ConclusionWe suggest that these data can aid in the diagnosis of cervical sensory radiculopathy using low stimulation intensity and of those who have cervical sensory radiculopathy combined with CTS patients.

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Section: Discussionmentioning

confidence: 70%

Changes in Dermatomal Somatosensory Evoked Potentials according to Stimulation Intensity and Severity of Carpal Tunnel Syndrome

Sohn

Seo

Min

et al. 2012

J Korean Neurosurg Soc

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“…In general, the characteristic waveform of SSEP elicited by stimulating the tail nerves showed a typical initial small positive wave and a major negative wave (Figure 1), which is similar to the SSEP elicited using sciatic nerve stimulation reported elsewhere. 9,10 The descending and ascending NAP of tail nerves had a typical triphasic (positive, major negative, and positive) wave of similar latency, but in the descending recording we also recorded the large late responses after the initial triphasic NAP (Figures 2, 3). Baseline amplitude of SSEP and NAP, the latency of SSEP, and the nerve conduction velocity of NAP showed no significant differences between the 3 groups (Table 1).…”

Section: Electrophysiologic Findingsmentioning

confidence: 89%

Neurophysiologic Changes After Preganglionic and Postganglionic Nerve-Root Constriction

Matsuda

Tsai²,

Tseng³

et al. 2007

Spine

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“…Our work, in concordance with previous studies, supports the notion that SSEP monitoring alone can reduce postoperative paraplegia by 60% in spinal surgery. 15,18 However, SSEPs can remain completely normal during nerve root injury, owing to central amplification, 16,20,21 perhaps contributing to the relatively low sensitivity.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of somatosensory evoked potentials in evaluating new neurological deficits after spinal thoracic fusion and decompression

Melachuri

Stopera

Melachuri

et al. 2020

Journal of Neurosurgery: Spine

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OBJECTIVEPosterior thoracic fusion (PTF) is used as a surgical treatment for a wide range of pathologies. The monitoring of somatosensory evoked potentials (SSEPs) is used to detect and prevent injury during many neurological surgeries. The authors conducted a study to evaluate the efficacy of SSEPs in predicting perioperative lower-extremity (LE) neurological deficits during spinal thoracic fusion surgery.METHODSThe authors included patients who underwent PTF with SSEP monitoring performed throughout the entire surgery from 2010 to 2015 at the University of Pittsburgh Medical Center (UPMC). The sensitivity, specificity, odds ratio, and receiver operating characteristic curve were calculated to evaluate the diagnostic accuracy of SSEP changes in predicting postoperative deficits. Univariate analysis was completed to determine the impact of age exceeding 65 years, sex, obesity, abnormal baseline testing, surgery type, and neurological deficits on the development of intraoperative changes.RESULTSFrom 2010 to 2015, 771 eligible patients underwent SSEP monitoring during PTF at UPMC. Univariate and linear regression analyses showed that LE SSEP changes significantly predicted LE neurological deficits. Significant changes in LE SSEPs had a sensitivity and specificity of 19% and 96%, respectively, in predicting LE neurological deficits. The diagnostic odds ratio for patients with new LE neurological deficits who had significant changes in LE SSEPs was 5.86 (95% CI 2.74–12.5). However, the results showed that a loss of LE waveforms had a poor predictive value for perioperative LE deficits (diagnostic OR 1.58 [95% CI 0.19–12.83]).CONCLUSIONSPatients with new postoperative LE neurological deficits are 5.9 times more likely to have significant changes in LE SSEPs during PTF. Surgeon awareness of an LE SSEP loss may alter surgical strategy and positively impact rates of postoperative LE neurological deficit status. The relatively poor sensitivity of LE SSEP monitoring may indicate a need for multimodal neurophysiological monitoring, including motor evoked potentials, in thoracic fusion surgery.

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Value of Dermatomal Somatosensory Evoked Potentials in Detecting Acute Nerve Root Injury

Cited by 22 publications

References 30 publications

Changes in Dermatomal Somatosensory Evoked Potentials according to Stimulation Intensity and Severity of Carpal Tunnel Syndrome

Changes in Dermatomal Somatosensory Evoked Potentials according to Stimulation Intensity and Severity of Carpal Tunnel Syndrome

Neurophysiologic Changes After Preganglionic and Postganglionic Nerve-Root Constriction

The efficacy of somatosensory evoked potentials in evaluating new neurological deficits after spinal thoracic fusion and decompression

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