Descending Neurogenic Evoked Potentials Monitoring Is an Effective Alternative in Spinal Deformity Surgery Under Inhaled Anesthesia

Abstract

To evaluate the reliability of descending neurogenic evoked potentials (DNEP) monitoring in spinal deformity surgery under inhaled anesthesia. A total of 180 consecutive patients who underwent spinal deformity surgery in our scoliosis center from July 2014 to August 2016 were reviewed. Intraoperative monitoring including somatosensory evoked potentials (SEP), motor evoked potentials (MEP), and DNEP was conducted routinely throughout operation. Patients were divided into 2 groups according to anesthesia methods: group A (n= 72, inhaled anesthesia, SEP/DNEP) and group B (n= 108, total intravenous anesthesia, SEP/MEP/DNEP). Intraoperative monitoring data were collected and analyzed. Positive alerts were observed in 26 patients (14.5%), of whom 18 (10%) were confirmed as true-positive events in the study population. No false-negative events were recorded. In group A, the sensitivity and specificity of SEP and DNEP were 100% and 93.8% and 100% and 98.5%, respectively. For group B, the sensitivity and specificity of SEP/MEP and DNEP were 100% and 95.9% and 100% and 98%, respectively. DNEP monitoring seemed to be effective for the detection and prevention of iatrogenic neurologic deficits during spinal deformity surgery. This study indicates that DNEP was an effective alternative in spinal deformity surgery under inhaled anesthesia.