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Study Design: 

This was a retrospective analysis.

Objective: 

The objective of this study was to assess the intraoperative neuromonitoring auxiliary significance of descending neurogenic–evoked potential (DNEP) for motor-evoked potential (MEP) during severe spinal deformity surgery when MEP-positive event occurs.

Summary of Background Data: 

MEP detection is the most widely applied neurological monitoring technique in spinal deformity surgery. MEP is quite vulnerable to anesthesia, blood pressure, and other intraoperative factors, leading to a high false-positive rate of MEP (3.2%–45.0%), which has greatly interfered with the surgical process. At present, the widely used “presence-or-absence” alarm criteria of MEP is not enough to solve the problem of false positive of MEP.

Methods: 

A total of 205 cases undergoing severe spinal deformity correction were retrospectively studied. Overall, 74 MEP-positive cases were classified as 2 subgroups: DNEP (+) and DNEP (−) groups. The MEP recovery, wake-up test, and Frankle grade were used to assess the neurological functions. The perioperative and long-term neurological outcomes were assessed.

Results: 

There were significant differences in preoperative scoliosis angle and kyphosis angle between DNEP (−) and DNEP (+) groups. Patients in DNEP (−) group showed more MEP improvement (81.5%), compared with the DNEP (+) group (53.2%). The Wake-up test showed...(More)

For more info please read, Intraoperative Neuromonitoring Auxiliary Significance of DNEP for MEP-positive Event, by Journals.llw.com