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Transcranial motor-evoked potentials combined with response recording through compound muscle action potential as the sole modality of spinal cord monitoring in spinal deformity surgery.
Spine (Phila Pa 1976). 2008 May 01; 33(10):1100-6.S

Abstract

STUDY DESIGN

This study is a prospective review of all spinal cord monitoring procedures in our unit from 1999 to 2004 in patients undergoing spinal deformity correction surgery.

OBJECTIVE

To report the sensitivity and specificity of transcranial motor-evoked potentials (MEP) and compound muscle action potential (CMAP) monitoring as the sole modality in spinal deformity correction surgery.

SUMMARY OF BACKGROUND DATA

Combined spinal cord monitoring with somatosensory-evoked potentials and MEP has been widely used. The use of CMAP as the only modality has not been widely used and its efficacy has not been fully elucidated.

METHODS

The intraoperative monitoring outcomes were compared with patient's postoperative clinical outcomes. The sensitivity and specificity were calculated and determined for our monitoring protocol.

RESULTS

Transcranial MEPs were measured in 144 patients in 172 procedures. In 2 patients (3 procedures), we were unable to record any CMAPs. There were 15 intraoperative monitoring changes. There were no new postoperative neurological deficits.

CONCLUSION

The monitoring criteria are sufficiently strict to achieve a sensitivity of 1.0 and a specificity of 0.97. Monitoring of CMAPs alone has been adequate to avoid clinical neurological deficits.

Authors+Show Affiliations

Department of Orthopaedics, The Children's Hospital at Westmead, University of Sydney, Australia. brian.hsu@ozemail.com.auNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18449044

Citation

Hsu, Brian, et al. "Transcranial Motor-evoked Potentials Combined With Response Recording Through Compound Muscle Action Potential as the Sole Modality of Spinal Cord Monitoring in Spinal Deformity Surgery." Spine, vol. 33, no. 10, 2008, pp. 1100-6.
Hsu B, Cree AK, Lagopoulos J, et al. Transcranial motor-evoked potentials combined with response recording through compound muscle action potential as the sole modality of spinal cord monitoring in spinal deformity surgery. Spine. 2008;33(10):1100-6.
Hsu, B., Cree, A. K., Lagopoulos, J., & Cummine, J. L. (2008). Transcranial motor-evoked potentials combined with response recording through compound muscle action potential as the sole modality of spinal cord monitoring in spinal deformity surgery. Spine, 33(10), 1100-6. https://doi.org/10.1097/BRS.0b013e31816f5f09
Hsu B, et al. Transcranial Motor-evoked Potentials Combined With Response Recording Through Compound Muscle Action Potential as the Sole Modality of Spinal Cord Monitoring in Spinal Deformity Surgery. Spine. 2008 May 1;33(10):1100-6. PubMed PMID: 18449044.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transcranial motor-evoked potentials combined with response recording through compound muscle action potential as the sole modality of spinal cord monitoring in spinal deformity surgery. AU - Hsu,Brian, AU - Cree,Andrew K, AU - Lagopoulos,Jim, AU - Cummine,John L, PY - 2008/5/2/pubmed PY - 2008/5/16/medline PY - 2008/5/2/entrez SP - 1100 EP - 6 JF - Spine JO - Spine VL - 33 IS - 10 N2 - STUDY DESIGN: This study is a prospective review of all spinal cord monitoring procedures in our unit from 1999 to 2004 in patients undergoing spinal deformity correction surgery. OBJECTIVE: To report the sensitivity and specificity of transcranial motor-evoked potentials (MEP) and compound muscle action potential (CMAP) monitoring as the sole modality in spinal deformity correction surgery. SUMMARY OF BACKGROUND DATA: Combined spinal cord monitoring with somatosensory-evoked potentials and MEP has been widely used. The use of CMAP as the only modality has not been widely used and its efficacy has not been fully elucidated. METHODS: The intraoperative monitoring outcomes were compared with patient's postoperative clinical outcomes. The sensitivity and specificity were calculated and determined for our monitoring protocol. RESULTS: Transcranial MEPs were measured in 144 patients in 172 procedures. In 2 patients (3 procedures), we were unable to record any CMAPs. There were 15 intraoperative monitoring changes. There were no new postoperative neurological deficits. CONCLUSION: The monitoring criteria are sufficiently strict to achieve a sensitivity of 1.0 and a specificity of 0.97. Monitoring of CMAPs alone has been adequate to avoid clinical neurological deficits. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/18449044/Transcranial_motor_evoked_potentials_combined_with_response_recording_through_compound_muscle_action_potential_as_the_sole_modality_of_spinal_cord_monitoring_in_spinal_deformity_surgery_ L2 - http://dx.doi.org/10.1097/BRS.0b013e31816f5f09 DB - PRIME DP - Unbound Medicine ER -