title: Diagnostic accuracy of evoked potentials for functional impairment after contusive spinal cord injury in adult rats.
abstract: Iatrogenic spinal cord injury (SCI) is a cause of potentially debilitating post-operative neurologic complications. Currently, intra-operative neurophysiological monitoring (IONM) via somatosensory evoked potentials and motor-evoked potentials is used to detect and prevent impending SCI. However, no empirically validated interventions exist to halt the progression of iatrogenic SCI once it is detected. This is in part due to the lack of a suitable translational model that mimics the circumstances surrounding iatrogenic SCI detected via IONM. Here, we evaluate a model of simulated contusive iatrogenic SCI detected via IONM in adult female Sprague-Dawley rats. We show that transient losses of somatosensory evoked potentials responses are 88.24% sensitive (95% confidence interval [CI] 63.53-98.20) and 80% specific (95% CI 51.91-95.43) for significant functional impairment following simulated iatrogenic SCI. Similarly, we show that transient losses in motor-evoked potentials responses are 70.83% sensitive (95% CI 48.91-87.33) and 100% specific (95% CI 62.91-100.00) for significant functional impairment following simulated iatrogenic SCI. These results indicate that our model is a suitable replica of the circumstances surrounding clinical iatrogenic SCI.
authors.affiliation: Department of Neurologic Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA 15213, USA; Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address: thirumalapd@upmc.edu.
authors.forename: Parthasarathy
authors.initials: P
authors.lastname: Thirumala
authors.affiliation: Department of Neurologic Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA 15213, USA.
authors.forename: James
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Neurologic Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA 15213, USA.
authors.forename: Rohan
authors.initials: R
authors.lastname: Krishnan
authors.affiliation: Department of Neurologic Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA 15213, USA.
authors.forename: Nihita
authors.initials: N
authors.lastname: Manem
authors.affiliation: Department of Neurologic Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA 15213, USA.
authors.forename: Shreya
authors.initials: S
authors.lastname: Umredkar
authors.affiliation: Department of Neurologic Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA 15213, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Hamilton
authors.affiliation: Department of Neurologic Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA 15213, USA; Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Balzer
authors.affiliation: Department of Physical Medicine & Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Oudega
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D019054:Evoked Potentials, Motor / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D007049:Iatrogenic Disease / Q000517:prevention & control; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000209:etiology / Q000517:prevention & control*
keywords: Iatrogenic; Injury; MEP; Neurophysiology; SSEP; Spine