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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3753

Title: Feasibility of adjunct facial motor evoked potential monitoring to reduce the number of false-positive results during cervical spine surgery.
Other Titles: 頚椎手術術中神経モニタリングにおける偽陽性減少を目的とした顔面運動誘発電位の応用
Authors: Matsuoka, Ryuta
Takeshima, Yasuhiro
Hayashi, Hironobu
Takatani, Tsunenori
Nishimura, Fumihiko
Nakagawa, Ichiro
Motoyama, Yasushi
Park, Young-Su
Kawaguchi, Masahiko
Nakase, Hiroyuki
Keywords: cervical spine
facial nerve
intraoperative neuromonitoring
motor evoked potential
Issue Date: Dec-2019
Publisher: American Association of Neurological Surgeons
Citation: Journal of neurosurgery. Spine Vol.32 No.4 p.570-577 (2019 Dec)
Abstract: Objective: False-positive intraoperative muscle motor evoked potential (mMEP) monitoring results due to systemic effects of anesthetics and physiological changes continue to be a challenging issue. Although control MEPs recorded from the unaffected side are useful for identifying a true-positive signal, there are no muscles on the upper or lower extremities to induce control MEPs in cervical spine surgery. Therefore, this study was conducted to clarify if additional MEPs derived from facial muscles can feasibly serve as controls to reduce false-positive mMEP monitoring results in cervical spine surgery. Methods: Patients who underwent cervical spine surgery at the authors' institution who did not experience postoperative neurological deterioration were retrospectively studied. mMEPs were induced with transcranial supramaximal stimulation. Facial MEPs (fMEPs) were subsequently induced with suprathreshold stimulation. The mMEP and subsequently recorded fMEP waveforms were paired during each moment during surgery. The initial pair was regarded as the baseline. A significant decline in mMEP and fMEP amplitude was defined as > 80% and > 50% decline compared with baseline, respectively. All mMEP alarms were considered false positives. Based on 2 different alarm criteria, either mMEP alone or both mMEP and fMEP, rates of false-positive mMEP monitoring results were calculated. Results: Twenty-three patients were included in this study, corresponding to 102 pairs of mMEPs and fMEPs. This included 23 initial and 79 subsequent pairs. Based on the alarm criterion of mMEP alone, 17 false-positive results (21.5%) were observed. Based on the alarm criterion of both mMEP and fMEP, 5 false-positive results (6.3%) were observed, which was significantly different compared to mMEP alone (difference 15.2%; 95% CI 7.2%-23.1%; p < 0.01). Conclusions: fMEPs might be used as controls to reduce false-positive mMEP monitoring results in cervical spine surgery.
Description: 博士(医学)・甲第746号・令和2年6月30日
© Copyright 2019 American Association of Neurological Surgeons
The definitive version is available at " http://dx.doi.org/10.3171/2019.9.SPINE19800 "
URI: http://hdl.handle.net/10564/3753
ISSN: 15475654
Academic Degrees and number: 24601A746
Degree-granting date: 2020-06-30
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2020年度

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