Intraoperative somatosensory evoked potential monitoring during anterior cervical discectomy and fusion in nonmyelopathic patients—a review of 1,039 cases

Smith, Patrick N.; Balzer, Jeffrey; Khan, Mustafa; Davis, Rick; Crammond, Donald J.; Welch, William C.; Gerszten, Peter C.; Sclabassi, R.J.; Kang, James D.; Donaldson, William F.

doi:10.1016/j.spinee.2006.04.008

Cited by 84 publications

(47 citation statements)

References 29 publications

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“…19 Other studies suggest that use of IONM during cervical spine surgeries can actually misinform the surgeon and result in inaccurate intraoperative findings. 11,18 Alternatively, some researchers argue that IONM contributes to prevention of new postoperative neurological deficits in patients undergoing low-risk cervical spine surgeries. Roh et al reported that somatosensory evoked potential monitoring prompted an intervention for 2.1% of 809 patients consecutively undergoing cervical spine surgery and probably prevented neurological sequelae in 82% of patients for whom an intervention was made.…”

Section: Discussionmentioning

confidence: 99%

A socioeconomic analysis of intraoperative neurophysiological monitoring during spine surgery: national use, regional variation, and patient outcomes

James

Rughani

Dumont

2014

FOC

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Object In the United States in recent years, a dramatic increase in the use of intraoperative neurophysiological monitoring (IONM) during spine surgeries has been suspected. Myriad reasons have been proposed, but no clear evidence confirming this trend has been available. In this study, the authors investigated the use of IONM during spine surgery, identified patterns of geographic variation, and analyzed the value of IONM for spine surgery cases. Methods In this retrospective analysis, the Nationwide Inpatient Sample was queried for all spine surgeries performed during 2007–2011. Use of IONM (International Classification of Diseases, Ninth Revision, code 00.94) was compared over time and between geographic regions, and its effect on patient independence at discharge and iatrogenic nerve injury was assessed. Results A total of 443,194 spine procedures were identified, of which 85% were elective and 15% were not elective. Use of IONM was recorded for 31,680 cases and increased each calendar year from 1% of all cases in 2007 to 12% of all cases in 2011. Regional use of IONM ranged widely, from 8% of cases in the Northeast to 21% of cases in the West in 2011. Iatrogenic nerve and spinal cord injury were rare; they occurred in less than 1% of patients and did not significantly decrease when IONM was used. Conclusions As costs of spine surgeries continue to rise, it becomes necessary to examine and justify use of different medical technologies, including IONM, during spine surgery.

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Section: Discussionmentioning

confidence: 99%

A socioeconomic analysis of intraoperative neurophysiological monitoring during spine surgery: national use, regional variation, and patient outcomes

James

Rughani

Dumont

2014

FOC

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“…However, no statistical significant difference was found between the RD and MSC performances, indicating that these techniques are equivalent and both techniques could be employed for sensory response detection, with potential clinical and intra-operative application, during spine (Smith et al, 2007) and vascular (Astarci et al, 2007) surgeries. On the other hand, the simulated results showed that RD could perform better for higher SNR values, especially for low M-values.…”

Section: Discussionmentioning

confidence: 89%

Rice Detector: Proposal of a Novel Objective Response Detection Technique

Júnior¹,

Melges²,

Infantosi³

et al. 2013

RBEB

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“…A retrospective study with 1,055 patients demonstrated that SSEPs had a sensitivity of 52% and a specificity of 100% to predict postoperative neurological status in cervical spine and spinal cord surgery (Kelleher et al, 2008). Quadriparesis and paraplegia still resulted in patients with preserved SSEPs in anterior cervical fusion (Ben-David et al, 1987;Bose et al, 2004;Smith et al, 2007;Taunt et al, 2005). Simultaneous monitoring of SSEPs and MEPs has proven that MEP monitoring is more reliable than SSEP monitoring to predict postoperative motor deficits.…”

Section: Clinical Efficacy Of Sseps and Mepsmentioning

confidence: 99%