Somatosensory- and motor-evoked potential monitoring without a wake-up test during idiopathic scoliosis surgery. An accepted standard of care

Spine
Anne M PadbergK Bridwell

Abstract

This was a retrospective study of 500 patients undergoing corrective surgery between 1987 and 1997 for spinal deformity caused by idiopathic scoliosis. To report the sensitivity and specificity of somatosensory-evoked and neurogenic motor-evoked potentials monitoring and the requirements for an intraoperative wake-up test for all idiopathic scoliosis surgeries at a single institution. Intraoperative monitoring is recommended for use during corrective spinal surgery. Accepted monitoring standards and requirements for an intraoperative wake-up test are still debated. 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. 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 somatosens...Continue Reading

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