Somatosensory evoked potential monitoring in anterior thoracic vertebrectomy

Harel Deutsch, Marc Arginteanu, Karen Manhart, Noel Perin, Martin Camins, Frank Moore, A. Abe Steinberger, Donald J. Weisz

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

Object. Spine surgeons have used intraoperative cortical and subcortical somatosensory evoked potential (SSEP) monitoring to detect changes in spinal cord function when intraoperative procedures can be performed to prevent neurological deterioration. However, the reliability of SSEP monitoring as applied to anterior thoracic vertebral body resections has not been rigorously assessed. Methods. The authors retrospectively reviewed hospital charts and operating room records obtained between August 1993 and December 1998 and found that SSEP monitoring was used in 44 surgical procedures involving an anterior approach for thoracic vertebral body resections. There were no patients in whom SSEP changes did not return to baseline during the surgical procedure. Patients in four cases, despite their stable SSEP recordings throughout the procedure, were noted immediately postoperatively to have experienced significant neurological deterioration. The false- negative rate in SSEP monitoring was 9%. Sensitivity was determined to be 0%. Conclusions. It is important to recognize high false-negative rates and low sensitivity of SSEP monitoring when it is used to record spinal cord function during anterior approaches for thoracic vertebrectomies. The insensitivity of SSEPs for motor deterioration during anterior thoracic vertebrectomies is likely due to the limitation of SSEPs, which monitor only posterior column function whereas motor paths are conveyed in the anterior and anterolateral spinal cord. The authors believe that SSEPs can not be relied on to detect reversible spinal damage during anterior thoracic vertebrectomies.

Original languageEnglish
Pages (from-to)155-161
Number of pages7
JournalJournal of Neurosurgery
Volume92
Issue number2 SUPPL.
DOIs
StatePublished - Apr 2000

Keywords

  • Somatosensory evoked potential monitoring
  • Thoracic dsisc
  • Vertebrectomy

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