Somatosensory and motor evoked potentials during correction surgery of scoliosis in neurologically asymptomatic Chiari malformation-associated scoliosis: A comparison with idiopathic scoliosis

Shi, Bo; Qiu, Junyin; Xu, Liang; Yang, Li; Jiang, Dengxu; Xia, Sanqiang; Liu, Zhen; Sun, Xu; Shi, Benlong; Zhu, Zezhang; Qiu, Yong

doi:10.1016/j.clineuro.2020.105689

Cited by 9 publications

(16 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They also demonstrated that the coexistence of syringomyelia in Chiari malformation‐associated scoliosis resulted in a lower SSEP amplitude. In addition, previous studies reported that the incidence of asymmetrical SSEP between the concave and convex sides was14.6%–31.0% for idiopathic scoliosis patients and 31.7%–42% for Chiari malformation‐associated scoliosis patients 8 , 12 , 15 . In the current study, the inter‐side latency difference of more than 2.8 ms, amplitude of more than 1 μV, or absence of unilateral wave was defined as the asymmetrical SSEP between the concave and convex sides.…”

Section: Discussionmentioning

confidence: 97%

“…Shi et al 15 . retrospectively compared SSEP and MEP results between neurologically asymptomatic Chiari malformation‐associated scoliosis and idiopathic scoliosis patients, showing similar absolute values of IONM results.…”

Section: Discussionmentioning

confidence: 97%

“…The SSEP and MEP of the concave and convex sides were measured and recorded 15 . SSEP stimulation was delivered to each posterior tibial nerve at the ankle, and SSEP was recorded using a pin electrode at Cz with reference to Fz.…”

Section: Methodsmentioning

confidence: 99%

“…Shi et al 15 retrospectively compared SSEP and MEP results between neurologically asymptomatic Chiari malformationassociated scoliosis and idiopathic scoliosis patients, showing similar absolute values of IONM results. They also demonstrated that the coexistence of syringomyelia in Chiari malformation-associated scoliosis resulted in a lower SSEP amplitude.…”

Section: Difference Between the Concave And Convex Sidesmentioning

confidence: 97%

“…Notably, Shi et al 15 demonstrated a significant difference in the SSEP amplitude between Chiari malformationassociated scoliosis patients with and without syringomyelia. In addition to the fact that the SSEP latency and MEP amplitude showed significant differences between the concave and convex sides in the current study, we speculated that all IONM parameters could be influenced by intraspinal abnormalities, depending on the etiology.…”

Section: Difference Between the Concave And Convex Sidesmentioning

confidence: 99%

See 4 more Smart Citations

Intra‐Operative Neurophysiological Monitoring in Patients with Intraspinal Abnormalities Undergoing Posterior Spinal Fusion

Qiu

Liu

Shi

et al. 2022

Orthopaedic Surgery

Self Cite

View full text Add to dashboard Cite

Objective To analyze the intraoperative neurophysiological monitoring (IONM) data of patients with intraspinal abnormalities undergoing posterior spinal fusion and to determine how intraspinal abnormalities influence IONM results. Methods Patients with severe kyphoscoliosis and intraspinal abnormalities who underwent posterior spinal correction and fusion between September 2015 and January 2019 were retrospectively reviewed. Candidate intraspinal abnormalities included Chiari malformation, syringomyelia, split cord malformation, and tethered cord syndrome. Total intravenous anesthesia was administered, and no muscle relaxant or inhalation anesthesia was used for maintenance. IONM data, including somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP), were recorded. The P37 and N50 latencies and amplitude were recorded for SSEP, whereas only the amplitude was recorded for MEP. The possible high‐risk factors for abnormal IONM results were analyzed. Results The current study included 87 patients (40 men, 47 women) with an average age of 20.2 ± 10.4 years. The etiologies were neuromuscular in 45 patients, idiopathic in four, and congenital in 38. A total of 136 intraspinal abnormalities were detected, including Chiari malformation in 33 patients, syringomyelia in 55, split‐cord malformation in 25, and tethered cord syndrome in 23. Forty patients had one intraspinal abnormality, whereas 47 patients had two or three intraspinal abnormalities. The monitorabilities were 87.4% and 97.7% for the SSEP and MEP, respectively. SSEP alerts were reported in five patients and MEP alerts in four patients, and new neurological deficits were observed in three patients postoperatively. The sensitivity and specificity were 100% and 97.3% for SSEP, and 100% and 98.8% for MEP, respectively. A significant difference in MEP amplitude between the concave and convex sides was observed, while significantly higher SSEP latency was observed on the concave side in patients with preoperative neurological deficits. There were 52 (59.8%) patients with abnormal IONM data. Preoperative neurological deficits (χ 2 = 7.715, p = 0.005) and more than one intraspinal abnormality (χ 2 = 9.186, p = 0.004) indicated a higher risk of abnormal IONM data. Conclusions IONM can be effectively used in patients with intraspinal abnormalities who undergo posterior spinal fusion. Patients with preoperative neurological deficits and more than one intraspinal abnormality have a higher risk of abnormal IONM monitoring.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Section: Difference Between the Concave And Convex Sidesmentioning

confidence: 97%

Section: Difference Between the Concave And Convex Sidesmentioning

confidence: 99%

See 3 more Smart Citations