Causal factors for position-related SSEP changes in spinal surgery

Area of Science:

• Neurosurgery
• Neurophysiology
• Spine Surgery

Background:

• Somatosensory evoked potentials (SSEPs) effectively detect upper extremity positional injuries.
• Causal factors for patient risk in intraoperative SSEP changes are not well established.

Purpose of the Study:

• To identify causal factors for intraoperative SSEP changes related to patient positioning.
• To determine patient populations at higher risk for these adverse events.

Main Methods:

• Retrospective analysis of 398 patient charts and intraoperative neurophysiological monitoring data.
• Comparison of upper extremity SSEP adverse events with independent variables: sex, positioning, procedure length, and BMI.
• Statistical analysis using ANOVA, Chi-square, and independent samples t-tests.

Main Results:

• Males were at higher risk for isolated ulnar nerve SSEP adverse events (87.5%).
• Supine and prone positions were significant for isolated median nerve SSEP adverse events.
• Procedure length and BMI were statistically significant for various upper extremity SSEP adverse events.

Conclusions:

• Sex, patient positioning, procedure length, and BMI are key determinants of upper extremity neural compromise during thoracolumbar and lumbosacral spine surgeries.
• Identifying at-risk patients can guide preventative strategies to minimize SSEP changes.