These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Evaluation of a Combination of Waveform Amplitude and Peak Latency in Intraoperative Spinal Cord Monitoring.
    Author: Kobayashi K, Ando K, Shinjo R, Ito K, Tsushima M, Morozumi M, Tanaka S, Machino M, Ota K, Ishiguro N, Imagama S.
    Journal: Spine (Phila Pa 1976); 2018 Sep 01; 43(17):1231-1237. PubMed ID: 30106389.
    Abstract:
    STUDY DESIGN: Retrospective study. OBJECTIVE: The goal of the study was to investigate the significance of a change in latency in monitoring of transcranial muscle-action potential (Tc-MsEP) waveforms. SUMMARY OF BACKGROUND DATA: Tc-MsEP has become a common approach in spine surgery due to its sensitivity and importance in motor function. Many reports have defined the alarm point of Tc-MsEP waveform as a particular decrease in amplitude, but evaluation of the waveform latency has not attracted as much attention. METHODS: The subjects were 70 patients who underwent spine surgery using intraoperative Tc-MsEP monitoring. The peak latency was defined as the period from stimulation until the waveform amplitude reached its peak. Relationships with postoperative paralysis were examined separately for latency delays of 5% or more and 10% or more, and in combination with a decrease in amplitude of 70% or more from baseline. RESULTS: Acceptable baseline Tc-MsEP responses were obtained from 1225 of 1372 muscles in the extremities (89.3%). Seven of the 70 patients (10%) had postoperative paralysis. A decrease in intraoperative amplitude of 70% or more from baseline occurred in 25 cases, with sensitivity 100%, specificity 71%, false positive rate 29%, and positive predictive value (PPV) 28% for prediction of postoperative paralysis. Compared to baseline, 15 cases had a latency delay of 5% or more, which gave a sensitivity of 100%, specificity of 87%, false positive rate of 0%, and PPV 47%, and 8 cases had a delay of 10% or more, which gave a sensitivity of 86%, specificity of 97%, false positive rate of 3%, and PPV 75%. A combination of a decrease in amplitude of 70% or more from baseline and a delay in latency of 10% or more from baseline had a sensitivity of 86%, specificity of 98%, and a false positive rate of 2%, and PPV 86%. CONCLUSION: Combined use of latency and amplitude could lead to reduction of false positives and increase of PPV in Br(E)-MsEP monitoring. LEVEL OF EVIDENCE: 3.
    [Abstract] [Full Text] [Related] [New Search]