The diagnostic accuracy of somatosensory evoked potentials in evaluating neurological deficits during 1036 posterior spinal fusions. (2nd December 2017)

• Record Type: Journal Article
• Authors: Melachuri, Samyuktha R.; Kaur, Jaspreet; Melachuri, Manasa K.; Crammond, Donald J.; Balzer, Jeffrey R.; Thirumala, Parthasarathy D.
• Is Part Of: Neurological research. Volume 39:Number 12(2017)
• Page Start: 1073
• Page End: 1079
• Publication Date: 2017-12-02
• Subjects: Posterior lumbar fusion -- intraoperative monitoring -- somatosensory evoked potentials -- neurological deficit; Neurology -- Periodicals; Neurosciences -- Periodicals; 616.8005
• DOI: 10.1080/01616412.2017.1378413
• Languages: English
• ISSNs: 0161-6412

Abstract

Abstract: Background: The goal of this study is to assess the sensitivity and specificity of somatosensory evoked potentials (SSEPs) in predicting perioperative neurological deficits during posterior spinal fusions (PSF). Methods: This study examined the diagnostic accuracy of significant changes of SSEPs and multimodal monitoring to evaluate and predict post-operative neurological deficits after PSF. All 1036 patients underwent PSF at the University of Pittsburgh Medical Center from 2010 to 2012. Statistical analysis was completed using SPSS version 22. Results: Of the 1036 patients included in the study, 35 (3.38%) patients had significant SSEP changes. Out of the 35 patients with significant SSEP changes, 22 (62.86%) patients had significant lower extremity (LE) SSEP changes. Ten (45.5%) of LE SSEP changes were loss of responses. Gender, obesity, and abnormal baselines did not significantly affect patient outcomes. Significant LE changes had an odds ratio of 13.18, 95% CI [3.44, 50.56], and LE loss of waveforms had an odds ratio of 19.48, 95% CI [3.76, 100.75]. Conclusions: Patients with perioperative neurological deficits are 13 times more likely to have LE significant changes, and 19 times more likely to have a LE loss of SSEP responses. Our study results indicate that LE significant changes or LE loss of waveforms in SSEPs can serve as a marker of perioperative neurological deficits.