Use of somatosensory evoked potentials and transcranial electric motor evoked potentials in surgical correction of scoliosis secondary to Chiari malformation

English Keywords:Somatosensory evoked potentials  Motor evoked potentials  Chiarimalformation  Scoliosis

English Abstract:

  【Abstract】 Objectives: To evaluate the clinical values of somatosensory evoked potentials(SSEPs) and transcranial electric motor evoked potentials(TCeMEPs) during surgical correction of scoliosis secondary to Chiari malformation. Methods: 63 patients with scoliosis secondary to Chiari malformation undergoing posterior spinal fusion from October 2013 to July 2015 were retrospectively reviewed, among them the intraoperative monitoring data including SSEPs and TCeMEPs were collected. SSEPs were attempted in 63 patients, and TCeMEPs were attempted in 50 patients. The successful rate, alert rate, positive predictive value, negative predictive value, sensitivity and specificity of SSEPs and TCeMEPs and combined use of SSEPs and TCeMEPs were calculated, respectively. Differences in test performances among groups were analyzed by using Chi-square test. Results: The sucessful rate of SSEPs and TCeMEPs was 95% and 96%, respectively. By combined using SSEPs and TCeMEPs, the successful rate increased to 100%. The sensitivity and specificity were 100% and 95% for SSEPs, 100% and 98% for TCeMEPs, respectively. The sensitivity and specificity were both 100% by combined using SSEPs and TCeMEPs. The negative predictive values for all were 100%. No differences were noted among three modalities(P>0.05). The positive predictive value of SSEPs and TCeMEPs and combined using SSEPs and TCeMEPs were 25%, 50%and 100%, respectively. There were significant differences among these groups(P<0.05). Conclusions: SSEPs and TCeMEPs are responsible for different neural pathways. Combined use of them can increase predicitive value and provide satisfactorily successful rate, sensitivity and specificity during surgical correction of scoliosis secondary to Chiari malformation