Alarm Value of Somatosensory Evoked Potential in Idiopathic Scoliosis Surgery

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• 作者：Sheng-Li Huang¹ ; Hua-Guang Qi² ; Jing-Jie Liu³ ; Jia-Liang Li² ; Ya-Juan Huang¹ ; Li Xiang³ ; ^{lixiangey@sina.cn" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Alarm criterion ; Amplitude ; Idiopathic scoliosis ; Monitoring ; Somatosensory-evoked potential
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：92
• 期：Complete
• 页码：397-401
• 全文大小：854 K

文摘

Somatosensory evoked potential (SSEP) monitoring is performed to examine postoperative clinical findings when a monitoring event was noted intraoperatively and to ascertain the alarm threshold for intraoperative neural damage.

Methods

The tibial SSEP of both lower limbs was recorded intraoperatively in patients with idiopathic scoliosis. Change of SSEP amplitude as opposed to the baseline was categorized into 4 levels: decrease <40%, decrease of 40%–50%, decrease of 50%–60%, and decrease >60%. Postoperative neurologic function of patients was examined and compared with SSEP data.

Results

The baseline amplitude before incision was significantly different from the amplitude after spine exposure. An amplitude reduction of >60% during scoliosis correction procedures was observed in 6 legs, and 4 of them had postoperative deterioration in motor status. As the measure of threshold for alarm, an amplitude reduction of >50% compared with baseline resulted in more false-positive outcomes compared with amplitude attenuation of >60%.

Conclusions

Compared with the traditional SSEP baseline before skin incision, the baseline acquired after spine exposure results in more accurate monitoring. A >60% decrease in SSEP amplitude could be a more suitable alarm threshold.