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CORRESPONDENCE
Year : 2010  |  Volume : 58  |  Issue : 6  |  Page : 980

Somatosensory evoked potentials monitoring in cervical spine surgery


Department of Neurosurgery, University Hospital of Ioannina, Ioannina, Greece

Date of Acceptance07-Aug-2010
Date of Web Publication10-Dec-2010

Correspondence Address:
George A Alexiou
Department of Neurosurgery, University Hospital of Ioannina, Ioannina
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.73759

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How to cite this article:
Fotakopoulos G, Alexiou GA, Karagiorgiadis D, Voulgaris S. Somatosensory evoked potentials monitoring in cervical spine surgery. Neurol India 2010;58:980

How to cite this URL:
Fotakopoulos G, Alexiou GA, Karagiorgiadis D, Voulgaris S. Somatosensory evoked potentials monitoring in cervical spine surgery. Neurol India [serial online] 2010 [cited 2019 Dec 15];58:980. Available from: http://www.neurologyindia.com/text.asp?2010/58/6/980/73759


Sir,

We read the interesting recent article by Ayoub et al.[1] concerning the usefulness and cost-effectiveness of somatosensory evoked potentials (SSEPs) during cervical spine surgery. The authors studied 210 consecutive patients who underwent surgery via anterior or posterior approach and found that SSEPs could help in preventing postoperative neurological deficit by the early detection of vascular or mechanical compromise and the consequent adaptation of the anesthetic or surgical technique. Furthermore, after performing a cost analysis, the authors found that SSEPs proved to be cost-effective. [1]

Intraoperative electrophysiological monitoring has increasingly been used to prevent neurological injury during spine surgery. With SSEPs, the reported rate of false-positive recordings is up to 28%, depending upon the location and number of channels and recording sites. [2] Of late, transcranial motor-evoked potentials (TcMEPs) have been used for intraoperative monitoring during spine surgery and found to be incurring equivalent or lower costs compared to SSEPs. TcMEPs require the placement of 3 electrodes, whereas SSEPs require 8 electrodes. Our earlier studies and unpublished data show TcMEPs and free-running electromyography to be an effective method for monitoring spinal cord during surgery for tumor excision, lumbar stenosis and cervical disk herniation. [3],[4] Furthermore, TcMEPs may predict postoperative improvement. An increase in the TcMEPs amplitude of more than 50% and 30% in patients with lumbar stenosis and cervical disk herniation, respectively, has been shown to predict greater postoperative improvement. Thus, we feel routine use of TcMEPs during spine surgery offers several advantages without changing the overall procedure-related cost.

 
  References Top

1.Ayoub C, Zreik T, Sawaya R, Domloj N, Sabbagh A, Skaf G. Significance and cost-effectiveness of somatosensory evoked potential monitoring in cervical spine surgery. Neurol India 2010;58:424-8.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Lubicky JP, Spadaro JA, Yuan HA, Fredrickson BE, Henderson N. Variability ofsomatosensory cortical evoked potential monitoring during spinal surgery. Spine (Phila Pa 1976) 1989;14:790-8.  Back to cited text no. 2
    
3.Voulgaris S, Alexiou GA, Mihos E, Karagiorgiadis D, Zigouris A, Fotakopoulos G, et al. Posterior approach to ventrally located spinal meningiomas. Eur Spine J 2010;19:1195-9.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.Voulgaris S, Karagiorgiadis D, Alexiou GA, Mihos E, Zigouris A, Fotakopoulos G, et al. Continuous intraoperative electromyographic and transcranial motor evoked potential recordings in spinal stenosis surgery. J Clin Neurosci 2010;17:274-6.  Back to cited text no. 4
[PUBMED]  [FULLTEXT]  



This article has been cited by
1 The value of transcranial motor-evoked potentials and free-running electromyography in surgery for cervical disc herniation
Fotakopoulos, G. and Alexiou, G.A. and Pachatouridis, D. and Karagiorgiadis, D. and Konitsiotis, S. and Kyritsis, A.P. and Voulgaris, S.
Journal of Clinical Neuroscience. 2013; 20(2): 263-266
[Pubmed]
2 The value of transcranial motor-evoked potentials and free-running electromyography in surgery for cervical disc herniation
George Fotakopoulos,George A. Alexiou,Dimitrios Pachatouridis,Dimitrios Karagiorgiadis,Spyridon Konitsiotis,Athanasios P. Kyritsis,Spyridon Voulgaris
Journal of Clinical Neuroscience. 2013; 20(2): 263
[Pubmed] | [DOI]



 

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