Factors Related to False-Versus True-Positive Neuromonitoring Changes in Adolescent Idiopathic Scoliosis Surgery

• DOI: 10.1097/00007632-200204150-00009
• Publication Date: 2003-04-24T16:09:53Z
• Authors: Kenneth J. Noonan; Timothy Walker; Judy R. Feinberg; Michelle Nagel; William Didelot; Richard Lindseth
• Keywords: Somatosensory evoked potential; Idiopathic scoliosis

Study Design. A retrospective study of 134 adolescent patients who underwent surgical correction idiopathic scoliosis between June 1992 and August 1998 was conducted. Objective. To examine factors related to changes in somatosensory-evoked potentials with or without neurogenic motor-evoked potentials. Summary Background Data. Studies document demonstrate threshold criteria for neuromonitoring that predict spinal cord function. Rates false-negative occurrences are low, yet higher rates false-positive findings may result. Methods. All the had somatosensory monitoring, 71 both potential monitoring. Gender, age, curve types, duration surgery, type amount instrumentation, were examined their effects on Estimated blood volume loss as well high low mean arterial pressure its variance assessed at start, middle, conclusion procedure. Results. According findings, 122 (91%) no monitoring postoperative neurologic deficit. Six (4.5%) readings. a motor sensory deficit, all which resolved within 18 months. False-positive readings associated greater variability pressure. No consistent predictions could be made about incidence injury if returned baseline before end surgery. Conclusions. Questions remain predictive accuracy this study, there modest rate, continued use these methods is recommended. Higher seen lability wake-up test recommended cases occur because exist even when monitored variables return baseline.