title: Validity and reliability of spinal cord monitoring in neuromuscular spinal deformity surgery.
abstract: Somatosensory evoked potentials (SSEPs) have become a standard of care in surgery for spinal deformity. Recent reports in the literature have suggested SSEP monitoring is not efficacious in surgeries for patients with neuromuscular disease. Electrophysiologic data were retrospectively analyzed from 74 patients with various neuromuscular disorders undergoing spinal-deformity surgery from 1989 through February 1995 at this medical center. The monitoring protocol included SSEPs recorded from multiple sites located cortically, subcortically, and peripherally. Neurogenic motor evoked potentials (NMEPs) were also employed. Anesthetic regimens were controlled for compatibility with evoked potential monitoring. Use of this intraoperative monitoring protocol resulted in reliable data for 95% of the patient population having baseline responses. Findings suggest that evoked potentials can be used effectively during surgery for neuromuscular spinal deformity. Use of a specific protocol allowed acquisition of reliable data intraoperatively, suggesting these methods are a valid means of monitoring neurologic status.
authors.affiliation: Department of Orthopaedic Surgery, Washington University Medical Center, St. Louis, Missouri, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Padberg
authors.forename: M H
authors.initials: MH
authors.lastname: Russo
authors.forename: L G
authors.initials: LG
authors.lastname: Lenke
authors.forename: K H
authors.initials: KH
authors.lastname: Bridwell
authors.forename: R M
authors.initials: RM
authors.lastname: Komanetsky
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005069:Evaluation Studies as Topic; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D006801:Humans; D007432:Intraoperative Period; D007866:Leg / Q000503:physiopathology; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009460:Neurologic Examination; D009468:Neuromuscular Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D013116:Spinal Cord / Q000503:physiopathology*; D013122:Spinal Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*