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European Spine Journal
Published in: European Spine Journal 7/2015

01-11-2015 | Original Article

Intraoperative monitoring of somatosensory (SSEPs) and transcranial electric motor-evoked potentials (tce-MEPs) during surgical correction of neuromuscular scoliosis in patients with central or peripheral nervous system diseases

Authors: F. Pastorelli, M. Di Silvestre, F. Vommaro, E. Maredi, A. Morigi, M. R. Bacchin, S. Bonarelli, R. Plasmati, R. Michelucci, T. Greggi

Published in: European Spine Journal | Special Issue 7/2015

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Abstract

Purpose

Combined intraoperative monitoring (IOM) of transcranial electric motor-evoked potentials (tce-MEPs) and somatosensory-evoked potentials (SSEPs) is safe and effective for spinal cord monitoring during scoliosis surgery. However, the literature data regarding the reliability of spinal cord monitoring in patients with neuromuscular scoliosis are conflicting and need to be confirmed.

Methods

We reviewed IOM records of 40 consecutive patients with neuromuscular scoliosis related to central nervous system (CNS) (29 pts) or peripheral nervous system (PNS) (11 patients) diseases, who underwent posterior fusion with instrumentation surgery for spinal deformity. Multimodalitary IOM with SSEPs and tce-MEPs was performed.

Results

Spinal cord monitoring using at least one modality was attempted in 38/40 (95 %) patients. No false-negative results were present in either group, but a relatively high incidence of false-positive cases (4/29, 13.8 %) was noted in the CNS group. Two patients in the CNS group and one patient in the PNS group presented transient postoperative motor deficits (true positive), related to surgical manoeuvres in two cases and to malposition in the other one.

Conclusions

Multimodalitary IOM is safe and effective to detect impending spinal cord and peripheral nerves dysfunction in neuromuscular scoliosis surgery. However, the interpretation of neurophysiological data may be challenging in such patients, and the rate of false-positive results is high when pre-operatory motor deficits are severe.
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Metadata
Title
Intraoperative monitoring of somatosensory (SSEPs) and transcranial electric motor-evoked potentials (tce-MEPs) during surgical correction of neuromuscular scoliosis in patients with central or peripheral nervous system diseases
Authors
F. Pastorelli
M. Di Silvestre
F. Vommaro
E. Maredi
A. Morigi
M. R. Bacchin
S. Bonarelli
R. Plasmati
R. Michelucci
T. Greggi
Publication date
01-11-2015
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 7/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4282-6

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