Diagnostic utility of different types of somatosensory evoked potential changes in pediatric idiopathic scoliosis correction surgery.

Autor: Gorijala VK; Department of Neurological Surgery, Center for Clinical Neurophysiology, University of Pittsburgh Medical Center, UPMC, Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA, 15213, USA., Reddy RP; Pittsburgh Orthopedic Spine Research, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Anetakis KM; Department of Neurological Surgery, Center for Clinical Neurophysiology, University of Pittsburgh Medical Center, UPMC, Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA, 15213, USA., Balzer J; Department of Neurological Surgery, Center for Clinical Neurophysiology, University of Pittsburgh Medical Center, UPMC, Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA, 15213, USA., Crammond DJ; Department of Neurological Surgery, Center for Clinical Neurophysiology, University of Pittsburgh Medical Center, UPMC, Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA, 15213, USA., Shandal V; Department of Neurological Surgery, Center for Clinical Neurophysiology, University of Pittsburgh Medical Center, UPMC, Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA, 15213, USA., Shaw JD; Pittsburgh Orthopedic Spine Research, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Christie MR; Department of Neurology and Rehabilitation Medicine, Texas Scottish Rite Hospital, University of Texas Southwestern Medical Center, Dallas, TX, USA., Thirumala PD; Department of Neurological Surgery, Center for Clinical Neurophysiology, University of Pittsburgh Medical Center, UPMC, Presbyterian-Suite-B-400, 200 Lothrop Suite, Pittsburgh, PA, 15213, USA. thirumalapd@upmc.edu.; Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. thirumalapd@upmc.edu.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2024 Apr; Vol. 33 (4), pp. 1644-1656. Date of Electronic Publication: 2024 Jan 29.
DOI: 10.1007/s00586-023-08063-y
Abstrakt: Purpose: To evaluate the diagnostic accuracy of intraoperative somatosensory evoked potential (SSEP) monitoring and types of SSEP changes in predicting the risk of postoperative neurological outcomes during correction surgery for idiopathic scoliosis (IS) in the pediatric age group (≤ 21 years).
Methods: Database review was performed to identify literature on pediatric patients with IS who underwent correction with intraoperative neuromonitoring. The sensitivity, specificity, and diagnostic odds ratio (DOR) of transient and persistent SSEP changes and complete SSEP loss in predicting postoperative neurological deficits were calculated.
Results: Final analysis included 3778 patients. SSEP changes had a sensitivity of 72.9%, specificity of 96.8%, and DOR of 102.3, while SSEP loss had a sensitivity of 41.8%, specificity of 99.3%, and DOR of 133.2 for predicting new neurologic deficits. Transient and persistent SSEP changes had specificities of 96.8% and 99.1%, and DORs of 16.6 and 59, respectively.
Conclusion: Intraoperative SSEP monitoring can predict perioperative neurological injury and improve surgical outcomes in pediatric scoliosis fusion surgery.
Level of Evidence: Level 2. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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