Usefulness of multi-channels in intraoperative spinal cord monitoring: multi-center study by the monitoring committee of the Japanese Society for Spine Surgery and related research

Abstract

Object The purpose of this study is to analyze the data in terms of the number of channels employed to examine the usefulness of multi-channels in intraoperative spinal cord monitoring. Methods The prerequisites for inclusion in the baseline data were as follows: (1) cases in which only CMAP monitoring was conducted; (2) cases in which monitoring was conducted under the same stimulation condition and the recording condition. Cases where inhalation anesthesia was used or muscle relaxants were used as maintenance anesthesia was excluded from the baseline data. Of the 6,887 cases, 884 cases met the criteria. The items examined for each of the different numbers of channels were the sensitivity and specificity, the false positive rate, the false negative rate, and the coverage rate of postoperative motor deficit muscles. Result To examine these two items in terms of the number of channels, the 4-channel group had lower sensitivity and specificity scores compared with the 8-and 16-channel groups (4 channels 73/93 %, 8 channels 100/97 %, 16 channels 100/95 %). Only four channels were derived for these cases and the coverage of postoperative motor deficit muscles was 38 % with only 30 out of the 80 postoperative motor deficit muscles in total being monitored. In the 8-channel group, it was 60 % with 12 of 123Eur Spine J (2013( ) 22:1891( -1896( DOI 10.1007( /s00586-013-2722 the 20 postoperative motor deficit muscles being monitored. The 16-channel group had 100 % coverage rate of postoperative motor deficit muscles. Conclusion We suggest that multi-channel monitoring of at least eight channels is desirable for intraoperative spinal cord monitoring.

Transcranial motor evoked potential waveform changes in corrective fusion for adolescent idiopathic scoliosis

“…36 In a multicenter study of 204 scoliosis cases, Ito et al showed that multichannel monitoring using at least 8 channels is desirable for intraoperative spinal cord monitoring and has a sensitivity of 100% and a specificity of 95%. 12 cases with spinal deformity. 3 Ferguson et al found significant neuromonitoring changes in 47 (9.1%) of 519 AIS cases using Tc-MEP, 8 and Schwartz et al found relevant signal changes in 38 (3.4%) of 1121 AIS cases using both Tc-MEP and SSEP.…”

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

“…Recent studies have provided additional evidence for the usefulness of Multi-channel MEPs (at least 8 muscles) during spinal surgery (Ito et al, 2013), and other studies suggested that MEPs demonstrated greater sensitivity during ACDF surgery than SSEPs (Lee et al, 2006, Xu et al, 2011). However, since no previous studies have investigated multi-channel MEPs during ACDF surgery, the current study aims to evaluate the usefulness of multi-channel MEPs monitoring on post-operative motor deficits of ACDF surgery.…”

Postoperative Paralysis From Thoracic Ossification of Posterior Longitudinal Ligament Surgery Risk Factor of Neurologic Injury

“…As for certain cases that exhibited no difference in preoperative MMT but did exhibit significant difference in the rate of Tc -MEP derivation, it is thought that Tc -MEP may be able to indicate the condition of the spine more sensitively and thus can be an effective tool for predicting paralysis [10][11][12][13][14][15][16][17][18][19] . In particular, if the derivation rate of the lower limb muscles is below 50%, the spinal cord is in a critical condition, requiring a great deal of care during surgery.…”