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Association Between Motor-Evoked Potentials and Spinal Cord Damage Diagnosed With Magnetic Resonance Imaging After

Kohshi Hattori1, Kenji Yoshitani1, Shinya Kato1

  • 1National Cerebral and Cardiovascular Center, Osaka, Japan.

Journal of Cardiothoracic and Vascular Anesthesia
|January 15, 2019
PubMed
Abstract

Insights

Intraoperative motor-evoked potentials (MEP) changes strongly predict motor deficits after aortic surgery, but do not correlate with spinal cord infarction severity on MRI. This finding clarifies discrepancies in assessing neurological injury risk.

Area of Science:

  • Neurosurgery
  • Cardiovascular Surgery
  • Neurology

Background:

  • Postoperative motor deficits after thoracic and thoracoabdominal aortic surgery can occur.
  • Discrepancies exist between intraoperative motor-evoked potential (MEP) changes and spinal cord infarction severity diagnosed by MRI.
  • Clarifying this discrepancy is crucial for accurate neurological injury assessment.

Purpose of the Study:

  • To investigate the association between intraoperative MEP changes and spinal cord infarction severity.
  • To understand the relationship between MEP, MRI findings, and postoperative motor deficits.

Main Methods:

  • A multicenter retrospective study involving 1,245 patients undergoing thoracic and thoracoabdominal aortic repair.
  • Intraoperative MEP monitoring and postoperative spinal MRI were analyzed.
  • Logistic regression examined associations between MRI grade, MEP changes (<25% of control), and motor deficits.

Main Results:

  • MEP <25% of control values was significantly associated with motor deficits at discharge (OR, 130.0).
  • MEP changes were not significantly associated with the severity of spinal cord infarction (OR, 0.917).
  • Motor deficits at discharge were linked to severe spinal cord infarction (OR, 4.83) and MEP <25% (OR, 13.95).

Conclusions:

  • Intraoperative MEP <25% is a significant predictor of motor deficits at discharge following aortic surgery.
  • MEP changes do not correlate with the severity of spinal cord infarction as determined by MRI.
  • This highlights the importance of MEP monitoring for predicting functional outcomes.
Keywords:
magnetic resonance imagingmotor-evoked potentialpermanent motor deficitspinal cord injuryvascular surgery

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