Skip to main content

Advertisement

SpringerLink
Log in

Value of multi-channel somatosensory evoked potentials recording in patients undergoing scoliosis correction surgery

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

We aimed to investigate the value of intraoperative multi-channel recording of somatosensory evoked potentials (SSEPs) in patients undergoing posterior instrumentation surgery with fusion.

Methods

This study included 176 patients with scoliosis who underwent posterior correction surgery from January 2019 to June 2020. Among them, 88 patients underwent routine SSEPs monitoring via single-channel (Cz'-Fpz) cortical recording (control group), while the remaining 88 patients underwent multi-channel (Cz'-Fpz and C3'-C4') SSEPs monitoring in the cortex. Chi-square and Fisher’s exact tests were used to analyze the influence of age, spinal deformity classification, and Cobb angle on waveform differentiation and the success rate of SSEPs monitoring.

Results

Univariate analysis revealed that age, type of scoliosis, and Cobb angle exerted significant effects on the success rate of intraoperative SSEPs monitoring, and the SSEPs waveform differentiation rate was poorest among patients with congenital scoliosis. Intraoperative monitoring results indicated that the success rate of single-channel SSEPs monitoring was 90.9%, while that of multi-channel monitoring was 98.9% (P < 0.05). Among the intraoperative alarm cases, the incidence of adverse events after single-channel SSEPs monitoring was 66.7%, while the incidence of adverse events after multi-channel SSEPs monitoring was only 28.6%.

Conclusion

Multi-channel cortical SSEPs monitoring can effectively and accurately evaluate the function of the posterior column of the spinal cord. Use of multi-channel SSEP monitoring may help to improve the success rate of monitoring and reduce the incidence of postoperative adverse events in patients with congenital scoliosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. DiCindio S, Theroux M, Shah S, Miller F, Dabney K, Brislin RP, Schwartz D (2003) Multimodality monitoring of transcranial electric motor and somatosensory-evoked potentials during surgical correction of spinal deformity in patients with cerebral palsy and other neuromuscular disorders. Spine (Phila Pa 1976) 28(16):1851–1855 (discussion 1855-1856)

    Article  PubMed  Google Scholar 

  2. Nuwer MR, MacDonald DB, Gertsch J (2022) Monitoring scoliosis and other spinal deformity surgeries. Handb Clin Neurol 186:179–204

    Article  PubMed  Google Scholar 

  3. Brodsky MA, Anderson S, Murchison C, Seier M, Wilhelm J, Vederman A, Burchiel KJ (2017) Clinical outcomes of asleep vs awake deep brain stimulation for Parkinson disease. Neurology 89(19):1944–1950

    Article  PubMed  Google Scholar 

  4. Helbok R, Schiefecker AJ, Beer R, Dietmann A, Antunes AP, Sohm F, Fischer M, Hackl WO, Rhomberg P, Lackner P et al (2015) Early brain injury after aneurysmal subarachnoid hemorrhage: a multimodal neuromonitoring study. Crit Care 19:75

    Article  PubMed  PubMed Central  Google Scholar 

  5. Legatt AD, Emerson RG, Epstein CM, MacDonald DB, Deletis V, Bravo RJ, Lopez JR (2016) ACNS guideline: transcranial electrical stimulation motor evoked potential monitoring. J Clin Neurophysiol 33(1):42–50

    Article  PubMed  Google Scholar 

  6. Mooij JJ, Mustafa MK, van Weerden TW (2001) Hemifacial spasm: intraoperative electromyographic monitoring as a guide for microvascular decompression. Neurosurgery 49(6):1365–1370 (discussion 1370-1361)

    Article  CAS  PubMed  Google Scholar 

  7. Sasaki T, Itakura T, Suzuki K, Kasuya H, Munakata R, Muramatsu H, Ichikawa T, Sato T, Endo Y, Sakuma J et al (2010) Intraoperative monitoring of visual evoked potential: introduction of a clinically useful method. J Neurosurg 112(2):273–284

    Article  PubMed  Google Scholar 

  8. Nuwer MR, Cohen BH, Shepard KM (2013) Practice patterns for intraoperative neurophysiologic monitoring. Neurology 80(12):1156–1160

    Article  PubMed  Google Scholar 

  9. Qiu J, Li Y, Liu W, Zhu Z, Shi B, Liu Z, Sun X, Qiu Y (2021) Intra-operative neurophysiological monitoring in patients with dystrophic neurofibromatosis type 1 scoliosis. Somatosens Mot Res 38(2):95–100

    Article  PubMed  Google Scholar 

  10. Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE (1995) Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol 96(1):6–11

    Article  CAS  PubMed  Google Scholar 

  11. Renehan JR, Ye IB, Thomson AE, Pease TJ, Smith RA, Fencel R, Oster B, Cavanaugh D, Koh EY, Gelb DE et al (2022) Intraoperative sensory signals predict prognosis for patients with traumatic cervical spinal cord injury. World Neurosurg. https://doi.org/10.1016/j.wneu.2022.10.056

    Article  PubMed  Google Scholar 

  12. Seyal M, Emerson RG, Pedley TA (1983) Spinal and early scalp-recorded components of the somatosensory evoked potential following stimulation of the posterior tibial nerve. Electroencephalogr Clin Neurophysiol 55(3):320–330

    Article  CAS  PubMed  Google Scholar 

  13. Strahm C, Min K, Boos N, Ruetsch Y, Curt A (2003) Reliability of perioperative SSEP recordings in spine surgery. Spinal Cord 41(9):483–489

    Article  CAS  PubMed  Google Scholar 

  14. Owen JH, Naito M, Bridwell KH, Oakley DM (1990) Relationship between duration of spinal cord ischemia and postoperative neurologic deficits in animals. Spine (Phila Pa 1976) 15(9):846–851

    Article  CAS  PubMed  Google Scholar 

  15. Agarwal N, Shabani S, Huang J, Ben-Natan AR, Mummaneni PV (2022) Intraoperative monitoring for spinal surgery. Neurol Clin 40(2):269–281

    Article  PubMed  Google Scholar 

  16. Pastorelli F, Di Silvestre M, Plasmati R, Michelucci R, Greggi T, Morigi A, Bacchin MR, Bonarelli S, Cioni A, Vommaro F et al (2011) The prevention of neural complications in the surgical treatment of scoliosis: the role of the neurophysiological intraoperative monitoring. Eur Spine J 20(Suppl 1):S105-114

    Article  PubMed  Google Scholar 

  17. Shi B, Qiu J, Xu L, Li Y, Jiang D, Xia S, Liu Z, Sun X, Shi B, Zhu Z et al (2020) Somatosensory and motor evoked potentials during correction surgery of scoliosis in neurologically asymptomatic chiari malformation-associated scoliosis: a comparison with idiopathic scoliosis. Clin Neurol Neurosurg 191:105689

    Article  PubMed  Google Scholar 

  18. Sebel Ps (1988) Evoked Potential Monitoring in the Operating Room, 1st Edn. By Nuwer M. Published by Raven Press, New York, Pp. 246; indexed; illustrated. BJA: British Journal of Anaesthesia 60:123

  19. Jou IM (2000) Effects of core body temperature on changes in spinal somatosensory-evoked potential in acute spinal cord compression injury: an experimental study in the rat. Spine (Phila Pa 1976) 25(15):1878–1885

    Article  CAS  PubMed  Google Scholar 

  20. Thirumala PD, Bodily L, Tint D, Ward WT, Deeney VF, Crammond DJ, Habeych ME, Balzer JR (2014) Somatosensory-evoked potential monitoring during instrumented scoliosis corrective procedures: validity revisited. Spine J 14(8):1572–1580

    Article  PubMed  Google Scholar 

  21. Chau WW, Chu WC, Lam TP, Ng BK, Fu LL, Cheng JC (2016) Anatomical origin of abnormal somatosensory-evoked potential (SEP) in adolescent idiopathic scoliosis with different curve severity and correlation with cerebellar tonsillar level determined by MRI. Spine (Phila Pa 1976) 41(10):E598-604

    Article  PubMed  Google Scholar 

  22. Sarwark JF, Dabney KW, Salzman SK, Wakabayashi T, Kitadai HK, Beauchamp JT, Beckman AL, Bunnell WP (1988) Experimental scoliosis in the rat. I. Methodology, anatomic features and neurologic characterization. Spine (Phila Pa 1976) 13(5):466–471

    Article  CAS  PubMed  Google Scholar 

  23. Pincott JR, Taffs LF (1982) Experimental scoliosis in primates: a neurological cause. J Bone Joint Surg Br 64(4):503–507

    Article  CAS  PubMed  Google Scholar 

  24. Chen Z, Qiu Y, Ma W, Qian B, Zhu Z (2014) Comparison of somatosensory evoked potentials between adolescent idiopathic scoliosis and congenital scoliosis without neural axis abnormalities. Spine J 14(7):1095–1098

    Article  PubMed  Google Scholar 

  25. Chen X, Sterio D, Ming X, Para DD, Butusova M, Tong T, Beric A (2007) Success rate of motor evoked potentials for intraoperative neurophysiologic monitoring: effects of age, lesion location, and preoperative neurologic deficits. J Clin Neurophysiol 24(3):281–285

    Article  PubMed  Google Scholar 

  26. Gonzalez AA, Droker BS, Kim ES, Parikh P (2022) Success rate of obtaining baseline somatosensory and motor evoked potentials in 695 consecutive cranial and spine surgeries. J Clin Neurophysiol 39(6):513–518

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work was funded by grants provided by the: National Natural Science Foundation of China (82260181), Key project of Natural Science Basic Research Plan of Shaanxi Province (2022JZ-43).

Author information

Author notes

  1. Yang Yuan and Yongjie Zhang have contributed equally to this work.

Authors and Affiliations

  1. Department of Functional Examination, Honghui Hospital, Xi’an Jiaotong University, Xi’an, 710000, China

    Yang Yuan, Yongjie Zhang, Xiao Song, Xin Zhang, Chunjuan Li, Tao Yuan & Huaguang Qi

  2. Spine Hospital, Honghui Hospital, Xi’an Jiaotong University, Xi’an, 710000, China

    Liang Yan

Authors
  1. Yang Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yongjie Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiao Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xin Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chunjuan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tao Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Huaguang Qi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Liang Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Huaguang Qi or Liang Yan.

Ethics declarations

Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical approval

This study was approved by the Ethics Committee of the Affiliated Honghui Hospital of Xi 'an Jiaotong University, No.202212006.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yuan, Y., Zhang, Y., Song, X. et al. Value of multi-channel somatosensory evoked potentials recording in patients undergoing scoliosis correction surgery. Eur Spine J 32, 4045–4053 (2023). https://doi.org/10.1007/s00586-023-07899-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-023-07899-8

Keywords

Search

Navigation