TY - JOUR
T1 - Somatosensory- and motor-evoked potential monitoring without a wake-up test during idiopathic up test during idiopathic scoliosis surgery
T2 - An accepted standard of care
AU - Padberg, Anne M.
AU - Wilson-Holden, Tracy J.
AU - Lenke, Lawrence G.
AU - Bridwell, Keith H.
PY - 1998/6/15
Y1 - 1998/6/15
N2 - Study Design. This was a retrospective study of 500 patients undergoing corrective surgery between 1987 and 1997 for spinal deformity caused by idiopathic scoliosis. Objectives. To report the sensitivity and specificity of somatosensory-evoked and neurogenic motor-evoked potentials monitoring and the requirement for an intra-operative wake-up test for all idiopathic scoliosis surgeries at a single institution. Summary of Background Data. Intraoperative monitoring is recommended for use during corrective spinal surgery. Accepted monitoring standards and requirements for an intraoperative wake-up tests are still debated. Methods. The study group consisted of 500 patients undergoing corrective surgery for idiopathic scoliosis between 1987 and 1997. All patients were monitored using somatosensory-evoked and neurogenic motor-evoked potential techniques, using a standard protocol developed at this institution. Results. The false-positive rate (significant data change without postoperative neurologic deficit) was 0.014% (n = 7). The true-positive rate (degradation of data that met warning criteria, with a corresponding postoperative neurologic deficit) was 0.004% (n = 2). No false- negative results (normal data during with a postoperative neurologic deficit) were seen. The sensitivity of combined somatosensory-evoked and neurogenic motor-evoked potentials data in predicting neurologic status was 98.6%, and the specificity of normal data predicting normal findings in a neurologic examination was 100%. Conclusions. Combined somatosensory-evoked and neurogenic motor-evoked potentials monitoring during idiopathic scoliosis surgery represents a standard of care that obviates the need for an intraoperative wake-up test when reliable data are obtained and maintained.
AB - Study Design. This was a retrospective study of 500 patients undergoing corrective surgery between 1987 and 1997 for spinal deformity caused by idiopathic scoliosis. Objectives. To report the sensitivity and specificity of somatosensory-evoked and neurogenic motor-evoked potentials monitoring and the requirement for an intra-operative wake-up test for all idiopathic scoliosis surgeries at a single institution. Summary of Background Data. Intraoperative monitoring is recommended for use during corrective spinal surgery. Accepted monitoring standards and requirements for an intraoperative wake-up tests are still debated. Methods. The study group consisted of 500 patients undergoing corrective surgery for idiopathic scoliosis between 1987 and 1997. All patients were monitored using somatosensory-evoked and neurogenic motor-evoked potential techniques, using a standard protocol developed at this institution. Results. The false-positive rate (significant data change without postoperative neurologic deficit) was 0.014% (n = 7). The true-positive rate (degradation of data that met warning criteria, with a corresponding postoperative neurologic deficit) was 0.004% (n = 2). No false- negative results (normal data during with a postoperative neurologic deficit) were seen. The sensitivity of combined somatosensory-evoked and neurogenic motor-evoked potentials data in predicting neurologic status was 98.6%, and the specificity of normal data predicting normal findings in a neurologic examination was 100%. Conclusions. Combined somatosensory-evoked and neurogenic motor-evoked potentials monitoring during idiopathic scoliosis surgery represents a standard of care that obviates the need for an intraoperative wake-up test when reliable data are obtained and maintained.
KW - Idiopathic scoliosis
KW - Neurogenic motor evoked potentials
KW - Somatosensory- evoked potentials
KW - Stagnara wake-up test
UR - http://www.scopus.com/inward/record.url?scp=0032526343&partnerID=8YFLogxK
U2 - 10.1097/00007632-199806150-00018
DO - 10.1097/00007632-199806150-00018
M3 - Article
C2 - 9654631
AN - SCOPUS:0032526343
SN - 0362-2436
VL - 23
SP - 1392
EP - 1400
JO - Spine
JF - Spine
IS - 12
ER -