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Failure to generate baseline muscle motor evoked potentials during spine surgery: Risk factors and association with

Jun-Soon Kim1, Myoung-Jin Jang2, Seung-Jae Hyun3

  • 1Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|September 16, 2018
PubMed
Abstract

Insights

Preoperative factors like muscle weakness and MRI findings predict failed baseline motor evoked potentials (mMEPs) during spine surgery. Failure to generate mMEPs, especially in thoracic lesions, is linked to poorer surgical outcomes.

Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Neuromonitoring

Background:

  • Intraoperative neuromonitoring, including muscle motor evoked potentials (mMEPs), is crucial during spinal surgery.
  • Failure to obtain baseline mMEPs can complicate surgical decision-making and outcome prediction.

Purpose of the Study:

  • To identify predictors of baseline mMEP generation failure in spinal surgery.
  • To assess the association between baseline mMEP generation and postoperative functional outcomes.

Main Methods:

  • Retrospective review of 345 patients undergoing spine surgery with mMEP monitoring.
  • Analysis of demographic, clinical parameters, and mMEP recording results stratified by lesion location.

Main Results:

  • Preoperative Medical Research Council grade <3 was associated with mMEP failure for both cervical and thoracic lesions.
  • High intramedullary T2 signal intensity (cervical) and male sex (thoracic) also predicted mMEP failure.
  • Baseline mMEP failure was linked to poor functional outcomes in thoracic lesion patients.

Conclusions:

  • Factors like sex, radiological findings, and preoperative functional status influence baseline mMEP generation failure.
  • Failure to obtain baseline mMEPs, particularly in thoracic spine surgery, may indicate an increased risk of postoperative deficits.
Keywords:
Baseline motor evoked potentials generationIntraoperative neurophysiological monitoringMotor evoked potentialSpine surgery

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