Intra-operative MEP monitoring can work well in the patients with neural axis abnormality.

Abstract

To explain the intra-operative transcranial motor evoked potential (MEP) monitoring can work well in patients with neural axis abnormality (NAA). One hundred eighteen consecutive NAA and 334 adolescent idiopathic scoliosis (AIS) patients who underwent spinal deformity surgery between June 2010 and April 2013 in our spine center were included. The MEP data including the success rate of obtaining a baseline, amplitude, sensitivity and specificity were analyzed. High-efficiency MEPs baseline could be obtained in 117/118 NAA (74 congenital scoliosis, 32 neuromuscular scoliosis, 8 adult scoliosis, 3 congenital kyphoscoliosis and 1 neurofibromatosis scoliosis) and 334 AIS cases. They had an approximate level in success rate of MEPs baseline (99.2 vs. 99.7%) and MEPs amplitude (317μV, n=118; vs. 312μV, n=334). The sensitivity and specificity for MEP were 100 and 98.2% in patients with NAA. And the MEPs amplitude value fitted positive-skewed distribution in both of NAA and AIS. Intraoperative MEP monitoring can be used accurately and satisfactorily in NAA patients and show no difference compared with AIS.