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Neuroradiology

, Volume 61, Issue 2, pp 207–215 | Cite as

Predictive value of neurophysiologic monitoring during neurovascular intervention for postoperative new neurologic deficits

  • Sungjoon Lee
  • Doo Young Kim
  • Su Bin Kim
  • Woojin Kim
  • Mi-Ri Kang
  • Hye-Jin Kim
  • Ki Hwa Lee
  • Minwook Yoo
  • Byung-Sam Choi
  • Jung Soo Kim
  • Sun-Il Lee
  • Hae Yu Kim
  • Sung-Chul JinEmail author
Interventional Neuroradiology

Abstract

Purpose

Forms of intraoperative neurophysiologic monitoring (IONM), including somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs), have been widely used in the field of neurosurgery. This study aimed to evaluate the diagnostic efficacy of IONM in identifying intraoperative events and predicting postoperative neurologic deficits in neurovascular intervention.

Methods

From January 2013 to December 2016, we retrospectively reviewed patients who underwent neurovascular intervention under general anesthesia with the use of IONM. Associations between significant changes in MEPs or SSEPs which were defined as a decrease more than 50% in amplitude and/or an increase more than 10% in latency and any identifiable intraoperative events and/or postoperative neurologic deficits were determined. The sensitivity and specificity values for both MEPs and SSEPs were calculated.

Results

In total, 578 patients (175 men and 403 women) were included. Their mean age was 59.5 years. SSEP changes occurred in 1% (n = 6), and MEP changes occurred in 1.2% (n = 7). Four patients suffered postoperative neurologic deficits, and identifiable intraoperative events were observed in seven patients. Both SSEP and MEP changes were significantly associated with identifiable intraoperative events and/or postoperative neurologic deficits (p < 0.001, Fisher’s exact test). The calculated sensitivity and specificity of MEP monitoring were 50 and 99.5%, respectively. The sensitivity and specificity of SSEP monitoring were both 100%.

Conclusion

Intraoperative SSEP monitoring might be a reliable and sensitive method to surveil neurologic complications during neurovascular intervention. Intraoperative MEP monitoring appears to be feasible. However, it is unclear whether MEP monitoring has any additive benefit over SSEP monitoring.

Keywords

Endovascular surgery Neurophysiologic monitoring Intraoperative monitoring Somatosensory evoked potential Motor evoked potential 

Notes

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

For this type of retrospective study formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Sungjoon Lee
    • 1
  • Doo Young Kim
    • 1
  • Su Bin Kim
    • 1
  • Woojin Kim
    • 2
  • Mi-Ri Kang
    • 3
  • Hye-Jin Kim
    • 4
  • Ki Hwa Lee
    • 5
  • Minwook Yoo
    • 1
  • Byung-Sam Choi
    • 1
  • Jung Soo Kim
    • 1
  • Sun-Il Lee
    • 1
  • Hae Yu Kim
    • 1
  • Sung-Chul Jin
    • 1
    Email author
  1. 1.Department of NeurosurgeryInje University Haeundae Paik HospitalBusanRepublic of Korea
  2. 2.Department of Physical MedicineInje University Haeundae Paik HospitalBusanRepublic of Korea
  3. 3.Department of NeurologyBusan Paik HospitalBusanRepublic of Korea
  4. 4.Department of NeurologyBHS Hanseo HospitalBusanRepublic of Korea
  5. 5.Department of AnesthesiologyInje University Haeundae Paik HospitalBusanRepublic of Korea

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