title: 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: OBJECTIVE
  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.
  
  
  RESULTS
  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 the 20 postoperative motor deficit muscles being monitored. The 16-channel group had 100 % coverage rate of postoperative motor deficit muscles.
  
  
  CONCLUSIONS
  We suggest that multi-channel monitoring of at least eight channels is desirable for intraoperative spinal cord monitoring.
authors.affiliation: Department of Orthopedic Surgery, Nagoya University School of Medicine, 65 Tsurumai Showa-ward, Nagoya, Aichi 466-8550, Japan. z.ito@nifty.com
authors.forename: Zenya
authors.initials: Z
authors.lastname: Ito
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Matsuyama
authors.forename: Kenichi
authors.initials: K
authors.lastname: Shinomiya
authors.forename: Muneharu
authors.initials: M
authors.lastname: Ando
authors.forename: Shigenori
authors.initials: S
authors.lastname: Kawabata
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kanchiku
authors.forename: Takanori
authors.initials: T
authors.lastname: Saito
authors.forename: Masato
authors.initials: M
authors.lastname: Takahashi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Naoya
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Kei
authors.initials: K
authors.lastname: Yamada
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Kida
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Sho
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Satomi
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Tani
mesh_terms: D003625:Data Collection; D006801:Humans; D007564:Japan; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D019637:Orthopedic Procedures; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012955:Societies, Medical; D013116:Spinal Cord / Q000502:physiology*; D013131:Spine / Q000601:surgery*; D011795:Surveys and Questionnaires
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