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Erschienen in: European Spine Journal 11/2023

29.08.2023 | Original Article

Value of multi-channel somatosensory evoked potentials recording in patients undergoing scoliosis correction surgery

verfasst von: Yang Yuan, Yongjie Zhang, Xiao Song, Xin Zhang, Chunjuan Li, Tao Yuan, Huaguang Qi, Liang Yan

Erschienen in: European Spine Journal | Ausgabe 11/2023

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Abstract

Purpose

We aimed to investigate the value of intraoperative multi-channel recording of somatosensory evoked potentials (SSEPs) in patients undergoing posterior instrumentation surgery with fusion.

Methods

This study included 176 patients with scoliosis who underwent posterior correction surgery from January 2019 to June 2020. Among them, 88 patients underwent routine SSEPs monitoring via single-channel (Cz'-Fpz) cortical recording (control group), while the remaining 88 patients underwent multi-channel (Cz'-Fpz and C3'-C4') SSEPs monitoring in the cortex. Chi-square and Fisher’s exact tests were used to analyze the influence of age, spinal deformity classification, and Cobb angle on waveform differentiation and the success rate of SSEPs monitoring.

Results

Univariate analysis revealed that age, type of scoliosis, and Cobb angle exerted significant effects on the success rate of intraoperative SSEPs monitoring, and the SSEPs waveform differentiation rate was poorest among patients with congenital scoliosis. Intraoperative monitoring results indicated that the success rate of single-channel SSEPs monitoring was 90.9%, while that of multi-channel monitoring was 98.9% (P < 0.05). Among the intraoperative alarm cases, the incidence of adverse events after single-channel SSEPs monitoring was 66.7%, while the incidence of adverse events after multi-channel SSEPs monitoring was only 28.6%.

Conclusion

Multi-channel cortical SSEPs monitoring can effectively and accurately evaluate the function of the posterior column of the spinal cord. Use of multi-channel SSEP monitoring may help to improve the success rate of monitoring and reduce the incidence of postoperative adverse events in patients with congenital scoliosis.
Literatur
1.
Zurück zum Zitat DiCindio S, Theroux M, Shah S, Miller F, Dabney K, Brislin RP, Schwartz D (2003) 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 (Phila Pa 1976) 28(16):1851–1855 (discussion 1855-1856)CrossRefPubMed DiCindio S, Theroux M, Shah S, Miller F, Dabney K, Brislin RP, Schwartz D (2003) 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 (Phila Pa 1976) 28(16):1851–1855 (discussion 1855-1856)CrossRefPubMed
2.
Zurück zum Zitat Nuwer MR, MacDonald DB, Gertsch J (2022) Monitoring scoliosis and other spinal deformity surgeries. Handb Clin Neurol 186:179–204CrossRefPubMed Nuwer MR, MacDonald DB, Gertsch J (2022) Monitoring scoliosis and other spinal deformity surgeries. Handb Clin Neurol 186:179–204CrossRefPubMed
3.
Zurück zum Zitat Brodsky MA, Anderson S, Murchison C, Seier M, Wilhelm J, Vederman A, Burchiel KJ (2017) Clinical outcomes of asleep vs awake deep brain stimulation for Parkinson disease. Neurology 89(19):1944–1950CrossRefPubMed Brodsky MA, Anderson S, Murchison C, Seier M, Wilhelm J, Vederman A, Burchiel KJ (2017) Clinical outcomes of asleep vs awake deep brain stimulation for Parkinson disease. Neurology 89(19):1944–1950CrossRefPubMed
4.
Zurück zum Zitat Helbok R, Schiefecker AJ, Beer R, Dietmann A, Antunes AP, Sohm F, Fischer M, Hackl WO, Rhomberg P, Lackner P et al (2015) Early brain injury after aneurysmal subarachnoid hemorrhage: a multimodal neuromonitoring study. Crit Care 19:75CrossRefPubMedPubMedCentral Helbok R, Schiefecker AJ, Beer R, Dietmann A, Antunes AP, Sohm F, Fischer M, Hackl WO, Rhomberg P, Lackner P et al (2015) Early brain injury after aneurysmal subarachnoid hemorrhage: a multimodal neuromonitoring study. Crit Care 19:75CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Legatt AD, Emerson RG, Epstein CM, MacDonald DB, Deletis V, Bravo RJ, Lopez JR (2016) ACNS guideline: transcranial electrical stimulation motor evoked potential monitoring. J Clin Neurophysiol 33(1):42–50CrossRefPubMed Legatt AD, Emerson RG, Epstein CM, MacDonald DB, Deletis V, Bravo RJ, Lopez JR (2016) ACNS guideline: transcranial electrical stimulation motor evoked potential monitoring. J Clin Neurophysiol 33(1):42–50CrossRefPubMed
6.
Zurück zum Zitat Mooij JJ, Mustafa MK, van Weerden TW (2001) Hemifacial spasm: intraoperative electromyographic monitoring as a guide for microvascular decompression. Neurosurgery 49(6):1365–1370 (discussion 1370-1361)CrossRefPubMed Mooij JJ, Mustafa MK, van Weerden TW (2001) Hemifacial spasm: intraoperative electromyographic monitoring as a guide for microvascular decompression. Neurosurgery 49(6):1365–1370 (discussion 1370-1361)CrossRefPubMed
7.
Zurück zum Zitat Sasaki T, Itakura T, Suzuki K, Kasuya H, Munakata R, Muramatsu H, Ichikawa T, Sato T, Endo Y, Sakuma J et al (2010) Intraoperative monitoring of visual evoked potential: introduction of a clinically useful method. J Neurosurg 112(2):273–284CrossRefPubMed Sasaki T, Itakura T, Suzuki K, Kasuya H, Munakata R, Muramatsu H, Ichikawa T, Sato T, Endo Y, Sakuma J et al (2010) Intraoperative monitoring of visual evoked potential: introduction of a clinically useful method. J Neurosurg 112(2):273–284CrossRefPubMed
8.
Zurück zum Zitat Nuwer MR, Cohen BH, Shepard KM (2013) Practice patterns for intraoperative neurophysiologic monitoring. Neurology 80(12):1156–1160CrossRefPubMed Nuwer MR, Cohen BH, Shepard KM (2013) Practice patterns for intraoperative neurophysiologic monitoring. Neurology 80(12):1156–1160CrossRefPubMed
9.
Zurück zum Zitat Qiu J, Li Y, Liu W, Zhu Z, Shi B, Liu Z, Sun X, Qiu Y (2021) Intra-operative neurophysiological monitoring in patients with dystrophic neurofibromatosis type 1 scoliosis. Somatosens Mot Res 38(2):95–100CrossRefPubMed Qiu J, Li Y, Liu W, Zhu Z, Shi B, Liu Z, Sun X, Qiu Y (2021) Intra-operative neurophysiological monitoring in patients with dystrophic neurofibromatosis type 1 scoliosis. Somatosens Mot Res 38(2):95–100CrossRefPubMed
10.
Zurück zum Zitat Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE (1995) Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol 96(1):6–11CrossRefPubMed Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE (1995) Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol 96(1):6–11CrossRefPubMed
12.
Zurück zum Zitat Seyal M, Emerson RG, Pedley TA (1983) Spinal and early scalp-recorded components of the somatosensory evoked potential following stimulation of the posterior tibial nerve. Electroencephalogr Clin Neurophysiol 55(3):320–330CrossRefPubMed Seyal M, Emerson RG, Pedley TA (1983) Spinal and early scalp-recorded components of the somatosensory evoked potential following stimulation of the posterior tibial nerve. Electroencephalogr Clin Neurophysiol 55(3):320–330CrossRefPubMed
13.
Zurück zum Zitat Strahm C, Min K, Boos N, Ruetsch Y, Curt A (2003) Reliability of perioperative SSEP recordings in spine surgery. Spinal Cord 41(9):483–489CrossRefPubMed Strahm C, Min K, Boos N, Ruetsch Y, Curt A (2003) Reliability of perioperative SSEP recordings in spine surgery. Spinal Cord 41(9):483–489CrossRefPubMed
14.
Zurück zum Zitat Owen JH, Naito M, Bridwell KH, Oakley DM (1990) Relationship between duration of spinal cord ischemia and postoperative neurologic deficits in animals. Spine (Phila Pa 1976) 15(9):846–851CrossRefPubMed Owen JH, Naito M, Bridwell KH, Oakley DM (1990) Relationship between duration of spinal cord ischemia and postoperative neurologic deficits in animals. Spine (Phila Pa 1976) 15(9):846–851CrossRefPubMed
15.
Zurück zum Zitat Agarwal N, Shabani S, Huang J, Ben-Natan AR, Mummaneni PV (2022) Intraoperative monitoring for spinal surgery. Neurol Clin 40(2):269–281CrossRefPubMed Agarwal N, Shabani S, Huang J, Ben-Natan AR, Mummaneni PV (2022) Intraoperative monitoring for spinal surgery. Neurol Clin 40(2):269–281CrossRefPubMed
16.
Zurück zum Zitat Pastorelli F, Di Silvestre M, Plasmati R, Michelucci R, Greggi T, Morigi A, Bacchin MR, Bonarelli S, Cioni A, Vommaro F et al (2011) The prevention of neural complications in the surgical treatment of scoliosis: the role of the neurophysiological intraoperative monitoring. Eur Spine J 20(Suppl 1):S105-114CrossRefPubMed Pastorelli F, Di Silvestre M, Plasmati R, Michelucci R, Greggi T, Morigi A, Bacchin MR, Bonarelli S, Cioni A, Vommaro F et al (2011) The prevention of neural complications in the surgical treatment of scoliosis: the role of the neurophysiological intraoperative monitoring. Eur Spine J 20(Suppl 1):S105-114CrossRefPubMed
17.
Zurück zum Zitat Shi B, Qiu J, Xu L, Li Y, Jiang D, Xia S, Liu Z, Sun X, Shi B, Zhu Z et al (2020) Somatosensory and motor evoked potentials during correction surgery of scoliosis in neurologically asymptomatic chiari malformation-associated scoliosis: a comparison with idiopathic scoliosis. Clin Neurol Neurosurg 191:105689CrossRefPubMed Shi B, Qiu J, Xu L, Li Y, Jiang D, Xia S, Liu Z, Sun X, Shi B, Zhu Z et al (2020) Somatosensory and motor evoked potentials during correction surgery of scoliosis in neurologically asymptomatic chiari malformation-associated scoliosis: a comparison with idiopathic scoliosis. Clin Neurol Neurosurg 191:105689CrossRefPubMed
18.
Zurück zum Zitat Sebel Ps (1988) Evoked Potential Monitoring in the Operating Room, 1st Edn. By Nuwer M. Published by Raven Press, New York, Pp. 246; indexed; illustrated. BJA: British Journal of Anaesthesia 60:123 Sebel Ps (1988) Evoked Potential Monitoring in the Operating Room, 1st Edn. By Nuwer M. Published by Raven Press, New York, Pp. 246; indexed; illustrated. BJA: British Journal of Anaesthesia 60:123
19.
Zurück zum Zitat Jou IM (2000) Effects of core body temperature on changes in spinal somatosensory-evoked potential in acute spinal cord compression injury: an experimental study in the rat. Spine (Phila Pa 1976) 25(15):1878–1885CrossRefPubMed Jou IM (2000) Effects of core body temperature on changes in spinal somatosensory-evoked potential in acute spinal cord compression injury: an experimental study in the rat. Spine (Phila Pa 1976) 25(15):1878–1885CrossRefPubMed
20.
Zurück zum Zitat Thirumala PD, Bodily L, Tint D, Ward WT, Deeney VF, Crammond DJ, Habeych ME, Balzer JR (2014) Somatosensory-evoked potential monitoring during instrumented scoliosis corrective procedures: validity revisited. Spine J 14(8):1572–1580CrossRefPubMed Thirumala PD, Bodily L, Tint D, Ward WT, Deeney VF, Crammond DJ, Habeych ME, Balzer JR (2014) Somatosensory-evoked potential monitoring during instrumented scoliosis corrective procedures: validity revisited. Spine J 14(8):1572–1580CrossRefPubMed
21.
Zurück zum Zitat Chau WW, Chu WC, Lam TP, Ng BK, Fu LL, Cheng JC (2016) Anatomical origin of abnormal somatosensory-evoked potential (SEP) in adolescent idiopathic scoliosis with different curve severity and correlation with cerebellar tonsillar level determined by MRI. Spine (Phila Pa 1976) 41(10):E598-604CrossRefPubMed Chau WW, Chu WC, Lam TP, Ng BK, Fu LL, Cheng JC (2016) Anatomical origin of abnormal somatosensory-evoked potential (SEP) in adolescent idiopathic scoliosis with different curve severity and correlation with cerebellar tonsillar level determined by MRI. Spine (Phila Pa 1976) 41(10):E598-604CrossRefPubMed
22.
Zurück zum Zitat Sarwark JF, Dabney KW, Salzman SK, Wakabayashi T, Kitadai HK, Beauchamp JT, Beckman AL, Bunnell WP (1988) Experimental scoliosis in the rat. I. Methodology, anatomic features and neurologic characterization. Spine (Phila Pa 1976) 13(5):466–471CrossRefPubMed Sarwark JF, Dabney KW, Salzman SK, Wakabayashi T, Kitadai HK, Beauchamp JT, Beckman AL, Bunnell WP (1988) Experimental scoliosis in the rat. I. Methodology, anatomic features and neurologic characterization. Spine (Phila Pa 1976) 13(5):466–471CrossRefPubMed
23.
Zurück zum Zitat Pincott JR, Taffs LF (1982) Experimental scoliosis in primates: a neurological cause. J Bone Joint Surg Br 64(4):503–507CrossRefPubMed Pincott JR, Taffs LF (1982) Experimental scoliosis in primates: a neurological cause. J Bone Joint Surg Br 64(4):503–507CrossRefPubMed
24.
Zurück zum Zitat Chen Z, Qiu Y, Ma W, Qian B, Zhu Z (2014) Comparison of somatosensory evoked potentials between adolescent idiopathic scoliosis and congenital scoliosis without neural axis abnormalities. Spine J 14(7):1095–1098CrossRefPubMed Chen Z, Qiu Y, Ma W, Qian B, Zhu Z (2014) Comparison of somatosensory evoked potentials between adolescent idiopathic scoliosis and congenital scoliosis without neural axis abnormalities. Spine J 14(7):1095–1098CrossRefPubMed
25.
Zurück zum Zitat Chen X, Sterio D, Ming X, Para DD, Butusova M, Tong T, Beric A (2007) Success rate of motor evoked potentials for intraoperative neurophysiologic monitoring: effects of age, lesion location, and preoperative neurologic deficits. J Clin Neurophysiol 24(3):281–285CrossRefPubMed Chen X, Sterio D, Ming X, Para DD, Butusova M, Tong T, Beric A (2007) Success rate of motor evoked potentials for intraoperative neurophysiologic monitoring: effects of age, lesion location, and preoperative neurologic deficits. J Clin Neurophysiol 24(3):281–285CrossRefPubMed
26.
Zurück zum Zitat Gonzalez AA, Droker BS, Kim ES, Parikh P (2022) Success rate of obtaining baseline somatosensory and motor evoked potentials in 695 consecutive cranial and spine surgeries. J Clin Neurophysiol 39(6):513–518CrossRefPubMed Gonzalez AA, Droker BS, Kim ES, Parikh P (2022) Success rate of obtaining baseline somatosensory and motor evoked potentials in 695 consecutive cranial and spine surgeries. J Clin Neurophysiol 39(6):513–518CrossRefPubMed
Metadaten
Titel
Value of multi-channel somatosensory evoked potentials recording in patients undergoing scoliosis correction surgery
verfasst von
Yang Yuan
Yongjie Zhang
Xiao Song
Xin Zhang
Chunjuan Li
Tao Yuan
Huaguang Qi
Liang Yan
Publikationsdatum
29.08.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 11/2023
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-023-07899-8

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