Evidence-based guideline update: Intraoperative spinal monitoring with somatosensory and transcranial electrical motor evoked potentials - Report of the therapeutics and technology assessment subcommittee of the american academy of neurology and the american clinical neurophysiology society Review uri icon

Overview

MeSH Major

  • Evoked Potentials, Motor
  • Evoked Potentials, Somatosensory
  • Monitoring, Intraoperative
  • Spinal Cord
  • Spine

abstract

  • Four Class I and 8 Class II studies met inclusion criteria for analysis. The 4 Class I studies and 7 of the 8 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 changes. 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 changes. In the Class I studies, 16%-40% of the IOM patients with EP changes developed postoperative-onset paraparesis, paraplegia, or quadriplegia. IOM is established as effective to predict an increased risk of the adverse outcomes of paraparesis, paraplegia, and quadriplegia in spinal surgery (4 Class I and 7 Class II studies). Surgeons and other members of the operating team should be alerted to the increased risk of severe adverse neurologic outcomes in patients with important IOM changes (Level A).

publication date

  • February 21, 2012

Research

keywords

  • Review

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1212/WNL.0b013e318247fa0e

PubMed ID

  • 22351796

Additional Document Info

start page

  • 585

end page

  • 9

volume

  • 78

number

  • 8