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  • Title: Alarm Value of Somatosensory Evoked Potential in Idiopathic Scoliosis Surgery.
    Author: Huang SL, Qi HG, Liu JJ, Li JL, Huang YJ, Xiang L.
    Journal: World Neurosurg; 2016 Aug; 92():397-401. PubMed ID: 27241092.
    Abstract:
    BACKGROUND: Somatosensory evoked potential (SSEP) monitoring is performed to examine postoperative clinical findings when a monitoring event was noted intraoperatively and to ascertain the alarm threshold for intraoperative neural damage. METHODS: The tibial SSEP of both lower limbs was recorded intraoperatively in patients with idiopathic scoliosis. Change of SSEP amplitude as opposed to the baseline was categorized into 4 levels: decrease <40%, decrease of 40%-50%, decrease of 50%-60%, and decrease >60%. Postoperative neurologic function of patients was examined and compared with SSEP data. RESULTS: The baseline amplitude before incision was significantly different from the amplitude after spine exposure. An amplitude reduction of >60% during scoliosis correction procedures was observed in 6 legs, and 4 of them had postoperative deterioration in motor status. As the measure of threshold for alarm, an amplitude reduction of >50% compared with baseline resulted in more false-positive outcomes compared with amplitude attenuation of >60%. CONCLUSIONS: Compared with the traditional SSEP baseline before skin incision, the baseline acquired after spine exposure results in more accurate monitoring. A >60% decrease in SSEP amplitude could be a more suitable alarm threshold.
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