Role of multimodal intraoperative neurophysiological monitoring during positioning of patient prior to cervical spine surgery

Multi-channel motor evoked potential monitoring during anterior cervical discectomy and fusion

“…Positioning was reported as one of the etiological factors that can causes nerve compression or injury during spinal surgery (Anderson et al, 2001, Jones et al, 2004, Ofiram et al, 2006, Anastasian et al, 2009, Raynor et al, 2013). A recent study suggested that the use of IONM prior to positioning could reduce the likelihood of neural injury during positioning (Plata Bello et al, 2015). For patients with severe canal stenosis, the use of MEP and SSEP monitoring prior to positioning might reduce the likelihood of neurological injury or nerve compression.…”

Should evoked potential monitoring be used in degenerative cervical spine surgery? A systematic review

“…According to the search performed, a total of eight studies met the inclusion criteria and were included for review. Of these studies, one was a PCS [13], four were CS [2, 8, 24, 26], and three were RCS [11, 22, 35]. The studies included in the search reported data on a total of 1683 patients.…”

“…Types of monitoring included in our search were SSEP, MEP, and the combination thereof (MIOM). Two studies included patients monitored only by SSEP [8, 11], two studies included patients monitored only by MEP [2, 26], four studies included patients monitored by SSEP and MEP separately [13, 22, 24, 35], and one study included patients monitored by concomitant MIOM [35].…”

“…In the included studies, the sensitivity of SSEP was estimated to be between 22% [2] and 100% [11] with constant specificity of 100% [13, 14, 22, 24, 26, 35]. The sensitivity of MEP reported in the studies included in our search was estimated to be between 78% [2] and 100% [13, 14, 22, 24, 26, 35] with specificity ranging from 83.2% [26] to 100% [13, 17, 24]. Three studies [8, 11, 35] included in our search reported cases of false positives and false negatives during SSEP and MEP monitoring.…”

Corticobulbar motor evoked potentials from tongue muscles used as a control in cervical spinal surgery

“…MEPs elicited during surgery could be influenced by various non-surgically induced changes, such as: anesthetics, medication, body temperature, blood pressure, positioning, hypoxia, ischemia, beside surgically surgery-related changes (Fishback et al, 1995, Haghighi et al, 1993, MacDonald and Janusz, 2002, Plata Bello et al, 2015, Raynor et al, 2013, Simon et al, 2010). Therefore, neurophysiologists have to differentiate non-surgically vs surgically induced changes to the parameters of MEPs.…”