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Corresponding Author

Elsayed Abdelrahman Elmor

Document Type

Original Article

Abstract

Background: Spinal surgeries could be a high risk of injury to the spinal cord, spinal nerves, and or blood vessels that may result in neurological deficits, such as paralysis, muscle weakness, pain, sphincteric disturbances, and sexual dysfunction.

Aim: To assess the usefulness of MEP& SEP and the need for combined monitoring. Financial and risk-benefit ratio assessment of multimodality monitoring rather than unimodality monitoring. That was because of the financial burden in developing countries like Egypt. Everyone assessed the sensitivity, specificity, PPV, and NPV of MEP and SSEP alone and the assessment of multimodality sensitivity and specificity. Finally, an assessment of D-wave modality usage will be made.

Patient and Methods: A combined retrospective and prospective study was performed from 2016 to 2023 at the Neurosurgery Department, Al-Azhar University hospitals.

Results: The study included 20 males and 21 females with M: F ratio of 1:1.05, the “Mean” average age was 39.02 years, the overall sum of combined SSEPs & MEPs sensitivity 90.75%; specificity 88.75%; PPV 84.15%; NPV 93.93%. The surgeon may find it helpful to combine SSEPs and MEPs in the three stages of the surgery.

Conclusion: The perioperative usefulness of the IONM is still challenging and needs more work and studies due to the wide range of previously published research. The multimodal MEP & SEP Sensitivity was 90.75%; specificity 88.75%; PPV 84.15%; NPV 93.93%.

Abbreviation: SSEPs: Somato-Sensory Evoked Potentials, MEPs: Motor Evoked Potentials,PPV: positive predictive value, NPV: negative predictive value, IONM: intra-operative Neuro-Monitoring.

Keywords

Evoked Potentials; Spinal Surgery; SSEP; MEP

Subject Area

Neurosurgery

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