S3-4. New alarm point of transcranial electrical stimulation motor evoked potentials for intraoperative spinal cord monitoring. A prospective multicenter study of the Spinal Cord Monitoring Working Group of the Japanese Society for Spine Surgery and Related Research (JSSR)

2013 ◽  
Vol 124 (8) ◽  
pp. e21
Author(s):  
Sho Kobayashi ◽  
Yukihiro Matsuyama ◽  
Kenichi Sinomiya ◽  
Shigenori Kawabata ◽  
Muneharu Ando ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Electrical Stimulation ◽  
Multicenter Study ◽  
Japanese Society ◽  
Motor Evoked Potentials ◽  
Transcranial Electrical Stimulation ◽  
Spinal Cord Monitoring ◽  
Prospective Multicenter Study ◽  
Related Research ◽  
Intraoperative Spinal Cord Monitoring

A new alarm point of transcranial electrical stimulation motor evoked potentials for intraoperative spinal cord monitoring: a prospective multicenter study from the Spinal Cord Monitoring Working Group of the Japanese Society for Spine Surgery and Related Research

2014 ◽  
Vol 20 (1) ◽  
pp. 102-107 ◽  
Author(s):  
Sho Kobayashi ◽  
Yukihiro Matsuyama ◽  
Kenichi Shinomiya ◽  
Shigenori Kawabata ◽  
Muneharu Ando ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Multicenter Study ◽  
Japanese Society ◽  
Spinal Cord Tumor ◽  
Transcranial Electrical Stimulation ◽  
Spinal Cord Monitoring ◽  
Prospective Multicenter Study ◽  
Intramedullary Spinal Cord ◽  
Related Research ◽  
Intraoperative Spinal Cord Monitoring

Object Although multimodal intraoperative spinal cord monitoring provides greater accuracy, transcranial electrical stimulation motor evoked potential (TcMEP) monitoring became the gold standard for intraoperative spinal cord monitoring. However, there is no definite alarm point for TcMEPs because a multicenter study is lacking. Thus, based on their experience with 48 true-positive cases (that is, a decrease in potentials followed by a new neurological motor deficit postoperatively) encountered between 2007 and 2009, the authors set a 70% decrease in amplitude as the alarm point for TcMEPs. Methods A total of 959 cases of spinal deformity, spinal cord tumor, and ossification of the posterior longitudinal ligament (OPLL) treated between 2010 and 2012 are included in this prospective multicenter study (18 institutions). These institutions are part of the Japanese Society for Spine Surgery and Related Research monitoring working group and the study group on spinal ligament ossification. The authors prospectively analyzed TcMEP variability and pre- and postoperative motor deficits. A 70% decrease in amplitude was designated as the alarm point. Results There were only 2 false-negative cases, which occurred during surgery for intramedullary spinal cord tumors. This new alarm criterion provided high sensitivity (95%) and specificity (91%) for intraoperative spinal cord monitoring and favorable accuracy, except in cases of intramedullary spinal cord tumor. Conclusions This study is the first prospective multicenter study to investigate the alarm point of TcMEPs. The authors recommend the designation of an alarm point of a 70% decrease in amplitude for routine spinal cord monitoring, particularly during surgery for spinal deformity, OPLL, and extramedullary spinal cord tumor.

Transcranial electrical stimulation and intraoperative neurophysiology of the corticospinal tract

2012 ◽  
Author(s):  
Vedran Deletis ◽  
Francesco Sala ◽  
Sedat Ulkatan
Keyword(s):  
Spinal Cord ◽  
Electrical Stimulation ◽  
Corticospinal Tract ◽  
Motor Evoked Potentials ◽  
Transcranial Electrical Stimulation ◽  
Irreversible Damage ◽  
Two Factors ◽  
Brain And Spinal Cord ◽  
The Brain ◽  
Wave Collision

Transcranial electrical stimulation is a well-recognized method for corticospinal tract (CT) activation. This article explains the use of TES during surgery and highlights the physiology of the motor-evoked potentials (MEPs). It describes the techniques and methods for brain stimulation and recording of responses. There are two factors that determine the depth of the current penetrating the brain, they are: choice of electrode montage for stimulation over the scalp and the intensity of stimulation. D-wave collision technique is a newly developed technique that allows mapping intraoperatively and finding the anatomical position of the CT within the surgically exposed spinal cord. Different mechanisms may be involved in the pathophysiology of postoperative paresis in brain and spinal cord surgeries so that different MEP monitoring criteria can be used to avoid irreversible damage and accurately predict the prognosis.

scholarly journals Transcranial electrical stimulation motor-evoked potentials in a spinal cord ischaemia rabbit model

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Yucheng Lu ◽  
Baotao Lv ◽  
Qimin Song
Keyword(s):  
Spinal Cord ◽  
Electrical Stimulation ◽  
Evoked Potentials ◽  
Motor Evoked Potentials ◽  
Rabbit Model ◽  
Transcranial Electrical Stimulation ◽  
Spinal Cord Ischaemia ◽  
Ischaemic Damage ◽  
Vascular Ligation ◽  
Before And After

Abstract Background Spinal cord ischaemia animal models were established by selective ligation of the lumbar artery in a craniocaudal direction between the renal artery and the aortic bifurcation. Transcranial electrical stimulation motor-evoked potentials were measured to enable their use in future studies on spinal cord ischaemia protection. Methods Thirty-three New Zealand rabbits were randomly divided into 6 groups. Transcranial electrical stimulation motor-evoked potentials were recorded before vascular ligation, 30 min after vascular ligation, and 2 days after vascular ligation. Motor functions were assessed after surgery and 2 days after vascular ligation. The specimens were taken 2 days after ligation for histopathologic observation. Results With increased numbers of ligations, a transient extension of the latency became clear, but there were no significant differences in the statistical analysis. Analysis of variance after ligation at the same time in each group and t tests before and after ligation (P > 0.05) were not significant. One or 2 ligations did not cause spinal cord ischaemic damage. There were no significant differences before and after ligation for the amplitude (P > 0.05). With increased numbers of ligations, the amplitude before and after ligation was gradually reduced in the 3–5 ligation groups (P < 0.05). Conclusions Ligation of segmental spinal cord vessels on 1 or 2 levels did not cause ischaemic damage. Spinal cord ischaemia was observed after 3, 4, or 5 ligations. The amplitude was more sensitive to spinal cord ischaemia than latency. Spinal cord function can be predicted by early changes in the amplitude.

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