The diagnostic accuracy of somatosensory evoked potentials in evaluating neurological deficits during 1036 posterior spinal fusions.

BACKGROUND

The goal of this study is to assess the sensitivity and specificity of somatosensory evoked potentials (SSEPs) in predicting perioperative neurological deficits during posterior spinal fusions (PSF).

METHODS

This study examined the diagnostic accuracy of significant changes of SSEPs and multimodal monitoring to evaluate and predict post-operative neurological deficits after PSF. All 1036 patients underwent PSF at the University of Pittsburgh Medical Center from 2010 to 2012. Statistical analysis was completed using SPSS version 22.

RESULTS

Of the 1036 patients included in the study, 35 (3.38%) patients had significant SSEP changes. Out of the 35 patients with significant SSEP changes, 22 (62.86%) patients had significant lower extremity (LE) SSEP changes. Ten (45.5%) of LE SSEP changes were loss of responses. Gender, obesity, and abnormal baselines did not significantly affect patient outcomes. Significant LE changes had an odds ratio of 13.18, 95% CI [3.44, 50.56], and LE loss of waveforms had an odds ratio of 19.48, 95% CI [3.76, 100.75].

CONCLUSIONS

Patients with perioperative neurological deficits are 13 times more likely to have LE significant changes, and 19 times more likely to have a LE loss of SSEP responses. Our study results indicate that LE significant changes or LE loss of waveforms in SSEPs can serve as a marker of perioperative neurological deficits.