Correlation between preoperative somatosensory evoked potentials and intraoperative neurophysiological monitoring in spi
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ORIGINAL RESEARCH
Correlation between preoperative somatosensory evoked potentials and intraoperative neurophysiological monitoring in spinal cord tumors Jinyoung Park1 · Yong Eun Cho2 · Mina Park3 · Joowon Lee1 · Dawoon Kim1 · Yoon Ghil Park1,4 Received: 11 March 2020 / Accepted: 21 August 2020 © Springer Nature B.V. 2020
Abstract Intraoperative neurophysiological monitoring (IONM) is widely used in spinal cord tumors (SCTs) removal surgery. This study mainly hypothesized that patients with prolonged latency of preoperative somatosensory evoked potentials (preSEPLat) would have more deteriorated intraoperative evoked potentials. Among 506 patients who underwent SCTs removal surgery, 74 underwent both preSEPs and IONM. The correlation between preSEPLat and intraoperative SEPs (ioSEPs) was mainly analyzed, and subgroup analysis according to anatomical type was also conducted. Secondly, whether p reSEPLat related to intraoperative motor evoked potentials (ioMEPs) or postoperative motor deterioration (PMD) was analyzed. In addition, risk factors for PMD were examined among anatomical factors, including operation level, tumor-occupying area ratio, and anatomical type, as well as electrophysiological factors, such as p reSEPLat, ioSEPs, and ioMEPs. Changes in ioSEP and ioMEP were considered significant even if they were recovered before the end of the monitoring. Patients with prolonged preSEPLat were more likely to have significant ioSEP changes for intradural-extramedullary (IDEM) but not for intramedullary or extradural tumors. The anatomical type and tumor-occupying area ratio were prognostic factors for transient PMD, while the ioSEPs were the only prognostic factor for persisted PMD over 4 weeks after surgery. PreSEPs are helpful in predicting the significant changes in ioSEPs during IDEM tumor removal surgery. The tumor-occupying area ratio and anatomical type are contributing factors for the transient PMD, whereas ioSEPs are prognostic factors in predicting the PMD that persists over 4 weeks after SCTs removal surgery. To our knowledge, this is the first study that mainly focused on the correlations of preoperative and intraoperative evoked potentials. Keywords Somatosensory · Evoked potentials · Intraoperative neurophysiological monitoring · Spinal cord · Spinal cord tumors
* Yoon Ghil Park [email protected] Jinyoung Park [email protected] Yong Eun Cho [email protected] Mina Park [email protected] Joowon Lee [email protected] Dawoon Kim [email protected]
1
Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea
2
Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
3
Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
4
Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei
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