Failure to generate baseline muscle motor evoked potentials during spine surgery: Risk factors and association with the postoperative outcomes. Issue 11 (November 2018)

• Record Type: Journal Article
• Authors: Kim, Jun-Soon; Jang, Myoung-jin; Hyun, Seung-Jae; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib; Kim, Sung-Min; Park, Kyung Seok
• Is Part Of: Clinical neurophysiology. Volume 129:Issue 11(2018:Nov.)
• Page Start: 2276
• Page End: 2283
• Publication Date: 2018-11
• Subjects: Intraoperative neurophysiological monitoring -- Motor evoked potential -- Baseline motor evoked potentials generation -- Spine surgery; MEP(s) motor evoked potential(s) -- mMEP(s) muscle motor evoked potential(s) -- MRC Medical Research Council -- MRI magnetic resonance imaging -- HSI high signal intensity -- Del deltoid -- APB abductor pollicis brevis -- ADM abductor digiti minimi -- TA tibialis anterior -- AH abductor hallucis; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2018.08.001
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: The associated factors for baseline mMEP recording failure were different based on lesion locations. Preoperative motor power showed a close correlation with the failure rate of baseline mMEP generation. Baseline mMEP generation failure in thoracic lesion could indicate risk for postoperative deficits. Abstract: Objective: To identify factors associated with the failure to generate baseline muscle motor evoked potentials (mMEPs) during spinal surgery, and to determine the association between baseline mMEP generation and postoperative outcomes. Methods: A total of 345 patients who underwent spine surgery with intraoperative mMEP monitoring were included, and we retrospectively reviewed their demographic/clinical parameters, and mMEP recording results according to lesion locations. Results: Multivariable logistic regression analysis revealed that preoperative Medical Research Council grade of the weakest muscle <3 was significantly associated with failure of baseline mMEP generation in both cervical and thoracic lesions. In addition, high intramedullary T2 signal intensity on spine MRI for cervical lesions and male sex for thoracic lesions were also significantly associated with baseline mMEP generation failure. Moreover, the failure of baseline mMEP generation was a significantly associated factor for poor functional outcome in patients with thoracic lesions. Conclusion: Sex, radiological abnormality, and preoperative functional status were associated with baseline mMEP generation failure during spine surgery with different patterns according to lesion location. Moreover, baseline mMEP generation failure in thoracic lesion could be associated with risk of postoperative deficits. Significance: The risk of baseline mMEP recording failure could be evaluated based on preoperative clinical parameters.