Intraoperative neurophysiological monitoring during spine surgery: An update

Current Opinion in Orthopaedics

Volumn 15, Issue 3, 2004, Pages 154-158

  Deletis, Vedran ^a   Sala, Francesco ^b  

^a BETH ISRAEL MEDICAL CENTER   (United States)

^b UNIVERSITY OF VERONA   (Italy)

Author keywords

Intraoperative monitoring; Motor evoked potentials; Orthopedic surgery; Somatosensory evoked potentials

Indexed keywords

BLOOD PRESSURE; BODY TEMPERATURE; COST EFFECTIVENESS ANALYSIS; DECOMPRESSION; EPIDURAL SPACE; EVOKED MUSCLE RESPONSE; EVOKED SOMATOSENSORY RESPONSE; HUMAN; HYPOTENSION; HYPOTHERMIA; INTERVERTEBRAL DISKECTOMY; INTRAOPERATIVE PERIOD; KYPHOSIS; MEDICAL INFORMATION; METHODOLOGY; NEUROLOGICAL COMPLICATION; NEUROPHYSIOLOGY; ORTHOPEDIC SURGERY; PARAPLEGIA; PATIENT MONITORING; PRIORITY JOURNAL; RELIABILITY; REVIEW; SCOLIOSIS; SIGNAL TRANSDUCTION; SPINAL CORD; SPINE MALFORMATION; SPINE STABILIZATION; SPINE SURGERY; SURGICAL TECHNIQUE; VERTEBRECTOMY;

EID: 2442585711     PISSN: 10419918     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.bco.0000127314.99341.ad     Document Type: Review

References (24)

1. Minahan RE, Sepkuty JP, Lesser RP, et al.: Anterior spinal cord injury with preserved neurogenic "motor" evoked potentials. Clin Neurophysiol 2001, 112:1442-1450. This is a critical paper that unquestionably proves the unreliability of neurogenic model evoke potentials in monitoring corticospinal tracts.
2. Deletis V, et al.: Neurophysiological mechanisms underlying motor evoked potentials in anesthetized humans. Part 2. Relationship between epidurally and muscle recorded MEPs in man. Clin Neurophysiol 2001, 112:445-452.
3. Pelosi L, Lamb J, Grevitt M, et al.: Combined monitoring of motor and somato-sensory evoked potentials in orthopaedic spinal surgery. Clin Neurophysiol 2002, 113:1082-1091. Article showed benefit of combined monitoring using SEPs and MEPs and their close correlation with the wake-up test.
4. Nuwer MR Dawson EG, Carlson LG, et al.: Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol 1995, 96:6-11.
5. Legatt AD: Current practice of motor evoked potential monitoring: results of a survey. J Clin Neurophysiol 2002, 19:454-460.
6. Toleikis JR, Skelly JP, Carlvin, et al.: Spinally elicited peripheral nerve responses are sensory rather than motor. Clin Neurophysiol 2000, 111:736-742.
7. Deletis V: The "motor" inaccuracy in neurogenic motor evoked potentials [editorial]. Clin Neurophysiol 2001, 112:1365-1366.
8. Dong CCJ, MacDonald DB, Janusz MT: Intraoperative spinal cord monitoring during descending thoracic and thoracoabdominal aneurysm surgery. Ann Thorac Surg 2002, 74:S1873-S1876.
9. MacDonald DB, Al Zayed Z, Khoudeir I, et al.: Monitoring scoliosis surgery with combined multiple pulse transcranial electric motor and cortical somatosensory-evoked potentials from the lower and upper extremities. Spine 2003, 28:194-203. This a comprehensive article that uses MEPs and SEPs for monitoring with obvious examples of their benefits.
10. DiCindio S, Theroux M, Shah S: Multimodality monitoring of transcranial electric motor and somatosensory-evoked potentials during surgical correction of spinal deformity in patients with cerebral palsy and other neuromuscular disorders. Spine 2003, 28:1851-1855. The authors presented data for combined use of SEPs and MEPs in a "very difficult to monitor" group of children with cerebral palsy and neuromuscular disorders during surgery for spine deformities.
11. MacDonald DB: Safety of intraoperative transcranial electrical stimulation motor evoked potential monitoring. J Clin Neurophysiol 2002, 19:416-429.
12. Jones SJ, Buonamassa S, Crockard HA: Two cases of quadriparesis following anterior cervical discectomy, with normal perioparative somatosensory evoked potentials. J Neurol Neurosurg Psychiatry 2003, 74:273-276. This is the first very well-documented and important report of quadriparetic patients after anterior cervical discectomy with preserved SEPs.
13. Deutsch H, Arginteanu M, Karen M, et al.: Somatosensory evoked potential monitoring in anterior thoracic vertebrectomy. J Neurosurg 2000, 92:155-161.
14. Seyal M, Mull B: Mechanisms of signal change during intraoperative somatosensory evoked potential monitoring of the spinal cord. J Clin Neurophysiol 2002, 19:409-415. This article concisely reviews mechanisms affecting amplitude and latency of SEPs during surgery. Some of these mechanisms are not directly related to anesthetic agents but should be recognized when critically analyzing waveforms intraoperatively.
15. Wiedemayer H, Fauser B, Sandalcioglu IE, et al.: The impact of neurophysiological intraoperative monitoring on surgical decisions: a critical analysis of 423 cases. J Neurosurg 2002, 96:255-262.
16. Owen JH: The application of intraoperative monitoring during surgery for spinal deformity. Spine 1999, 24:2649-2662.
17. Noonan KJ, Walker T, Feinberg JR, et al.: Factors related to false-versus true-positive neuromonitoring changes in adolescent idiopathic scoliosis surgery. Spine 2002, 27:825-830.
18. Polo A, Tersedor A, Poniagna-Soto J, et al.: Neurophysiological monitoring during scoliosis surgery using control hypotension. Rev Esp Anestesiol Reanim 2000, 47:367-370.
19. Jacobs MJ, Elenbaas TW, Schueink GWH, et al.: Assessment of spinal cord integrity during thoracoabdominal aortic aneurysm repair. Ann Thorac Surg 2002, 74:S1864-S1866.
20. Luk KD, Hu Y, Wong YW, et al.: Variability of somatosensory-evoked potentials in different stages of scoliosis surgery. Spine 1999, 24:1799-1804.
21. Sakamoto T, Kawaguchi M, Kakimoto M, et al.: The effect of hypothermia on myogenic motor-evoked potentials to electrical stimulation with a single pulse and a train of pulses under ropofol/ketamine/fentanyl anesthesia in rabbits. Anesth Analg 2003, 96:1692-1697.
22. Meylaerts SA, De Haan P, Kalkman CJ, et al.: The influence of regional spinal cord hypothermia on transcranial myogenic motor-evoked potential monitoring and the efficacy of spinal cord ischemia detection. J Thorac Cardiovasc Surg 1999, 118:1038-1045.
23. Berkowitz M: Assessing the socioeconomic impact of improved treatment of head and spinal cord injuries. J Emerg Med 1993, 11 (suppl 1):63-67.
24. Kombos T, Suess O, Brock M: Cost analysis of intraoperative neurophysiological monitoring (IOM). Zentralbl Neurochir 2002, 63:141-145.