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Correlation between preoperative somatosensory evoked potentials and intraoperative neurophysiological monitoring in spinal cord tumors

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Abstract

Intraoperative neurophysiological monitoring (IONM) is widely used in spinal cord tumors (SCTs) removal surgery. This study mainly hypothesized that patients with prolonged latency of preoperative somatosensory evoked potentials (preSEPLat) would have more deteriorated intraoperative evoked potentials. Among 506 patients who underwent SCTs removal surgery, 74 underwent both preSEPs and IONM. The correlation between preSEPLat and intraoperative SEPs (ioSEPs) was mainly analyzed, and subgroup analysis according to anatomical type was also conducted. Secondly, whether preSEPLat related to intraoperative motor evoked potentials (ioMEPs) or postoperative motor deterioration (PMD) was analyzed. In addition, risk factors for PMD were examined among anatomical factors, including operation level, tumor-occupying area ratio, and anatomical type, as well as electrophysiological factors, such as preSEPLat, ioSEPs, and ioMEPs. Changes in ioSEP and ioMEP were considered significant even if they were recovered before the end of the monitoring. Patients with prolonged preSEPLat were more likely to have significant ioSEP changes for intradural-extramedullary (IDEM) but not for intramedullary or extradural tumors. The anatomical type and tumor-occupying area ratio were prognostic factors for transient PMD, while the ioSEPs were the only prognostic factor for persisted PMD over 4 weeks after surgery. PreSEPs are helpful in predicting the significant changes in ioSEPs during IDEM tumor removal surgery. The tumor-occupying area ratio and anatomical type are contributing factors for the transient PMD, whereas ioSEPs are prognostic factors in predicting the PMD that persists over 4 weeks after SCTs removal surgery. To our knowledge, this is the first study that mainly focused on the correlations of preoperative and intraoperative evoked potentials.

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Acknowledgements

We would like to thank Editage (https://www.editage.co.kr) for English language editing.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jinyoung Park, Joowon Lee, Dawoon Kim & Yoon Ghil Park

  2. Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Yong Eun Cho

  3. Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Mina Park

  4. Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University, 20, Eonju-ro 63-gil, Gangnam-gu, Seoul, 06229, Republic of Korea

    Yoon Ghil Park

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  1. Jinyoung Park
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Correspondence to Yoon Ghil Park.

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The study protocol was approved by the institutional review board of Gangnam Severance Hospital (3-2019-0108) and conducted in accordance with the Declaration of Helsinki.

Research involving human participants and/or animals

This retrospective cohort study was based on the preexisting medical data review, and did not prospectively include human participants or animals.

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Park, J., Cho, Y.E., Park, M. et al. Correlation between preoperative somatosensory evoked potentials and intraoperative neurophysiological monitoring in spinal cord tumors. J Clin Monit Comput 35, 979–991 (2021). https://doi.org/10.1007/s10877-020-00584-x

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  • DOI: https://doi.org/10.1007/s10877-020-00584-x

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