Evidence-based guideline update: intraoperative spinal monitoring with somatosensory and transcranial electrical motor evoked potentials*

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
M R NuwerAmerican Association of Neuromuscular and Electrodiagnostic Medicine

Abstract

To evaluate whether spinal cord intraoperative monitoring (IOM) with somatosensory and transcranial electrical motor evoked potentials (EPs) predict adverse surgical outcomes. A panel of experts reviewed the results of a comprehensive literature search and identified published studies relevant to the clinical question. These studies were classified according to the evidence-based methodology of the American Academy of Neurology. Objective outcomes of postoperative onset of paraparesis, paraplegia, and quadriplegia were used because no randomized or masked studies were available. Four class I and eight class II studies met inclusion criteria for analysis. The four class I studies and seven of the eight class II studies reached significance in showing that paraparesis, paraplegia, and quadriplegia occurred in the IOM patients with EP changes compared with the IOM group without EP change. All studies were consistent in showing all occurrences of paraparesis, paraplegia, and quadriplegia in the IOM patients with EP changes, with no occurrences of paraparesis, paraplegia, and quadriplegia in patients without EP change. In the class I studies, 16% to 40% of the IOM patients with EP changes developed postoperative-onset paraparesis, p...Continue Reading

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Citations

Jan 4, 2017·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Blair Calancie
Sep 19, 2014·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Parastou ShilianAndres A Gonzalez
Oct 12, 2017·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Hamdy AwadCharles D Collard
Jun 23, 2018·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Jonathan H ChenAndres A Gonzalez
Apr 3, 2014·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Alexandru CălinMirela V Simon
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May 23, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Justin W SilversteinHargovind DeWal
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Sep 30, 2015·Anesthesiology·Angela S KoglerThomas F Floyd
Jan 1, 2015·International Anesthesiology Clinics·Jay L Shils, Tod B Sloan
Aug 1, 2018·Spine·Jefferson Walter DanielAndrei Fernandes Joaquim
Aug 30, 2016·AORN Journal·Lloyd A Hey, Thomas C Turner
Jan 30, 2019·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Ann Ali AbdelkaderRania A AlMahdy
Jan 15, 2020·Global Spine Journal·Anastasios CharalampidisMichael G Fehlings
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Jun 4, 2019·Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre·Athanasios I TsirikosCiara Michaelson

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