title: Exploration of the Intraoperative Motor Evoked Potential.
abstract: METHODS
  Prospective study.
  
  
  OBJECTIVE
  The objectives of the study was to (1) seek a relation between motor evoked potential (MEP) and corresponding cervical cord function in cervical compression myelopathy (CCM) and (2) explore a high-sensitive MEP range that can predict the intraoperative monitoring change ahead in cervical spine surgery.
  
  
  BACKGROUND
  There have been lots of controversies concerning the application of transcranial MEP in cervical spine surgery.
  
  
  METHODS
  We prospectively investigate 86 consecutive patients with CCM who underwent posterior laminoplasty or laminectomy from December 2012 to September 2014. The 18-point modified Japanese Orthopedic Association (mJOA) score and intraoperative MEP were used for neurological and electrophysiological assessment. Statistical correlation analysis and curve fitting were used to definite the relationship between MEP and corresponding cervical cord function. And a novel concept of high-sensitive MEP range was firstly addressed for predicting the intraoperative monitoring change ahead in CCM.
  
  
  RESULTS
  Our results showed that the preoperative mJOA score of lower extremity presented a significant correlation with MEP parameters in CCM, and the correlation was expressed in an exponential relationship. The monitoring change in CCM often appeared at a high-sensitive MEP range (amplitude <159 μV or latency >36.1 ms). In addition, the high-sensitive MEP ranges not only included MEP degeneration but also a larger number of MEP improvement cases.
  
  
  CONCLUSIONS
  Intraoperative MEP may imply an exponential correlation with the corresponding cervical cord function in CCM. And we first characterize a high-sensitive MEP range which may indicate high risk for the impending monitoring change during cervical cord decompression and we must watch more closely.
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Shujie
authors.initials: S
authors.lastname: Wang
authors.forename: Ye
authors.initials: Y
authors.lastname: Tian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods* / Q000706:statistics & numerical data*; D007796:Laminectomy / Q000379:methods; D065406:Laminoplasty / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013117:Spinal Cord Compression / Q000503:physiopathology* / Q000601:surgery*; D055815:Young Adult