Intraoperative neuroelectrophysiological monitoring of spinal cavernous vascular malformations: sensitivity and specificity of monitoring and warning criteria

Abstract

Objective To analyze the sensitivity and specificity of neuroelectrophysiological monitoring and warning criterion in the spinal cord cavernous malformations surgery. Methods A total of 64 patients with spinal cord cavernous malformation underwent surgical treatment were collected from November 2012 to March 2016. All patients underwent intraoperative monitoring of motor⁃evoked potential (MEP) and somatosensory ⁃ evoked potential (SEP). Multimodal monitoring combined MEP amplitude decreased ≥ 80% with SEP was performed to predict the postoperative neurological function defect of patients. McCormick grade as "gold standard" was used to calculate sensitivity, specificity, positive predictive value and negative predictive value. Results The sensitivity, specificity, positive predictive value and negative predictive value were 75% (15/20), 78.57% (33/42), 62.50% (15/24) and 86.84% (33/38), respectively. Conclusions Intraoperative MEP combined with SEP monitoring can effectively predict the occurrence of new neurological deficits after operation. MEP amplitude reduction ≥ 80% can be used as the operation warning criterion. DOI:10.3969/j.issn.1672⁃6731.2020.11.007

Keywords

• vascular malformations
• spinal cord
• intraoperative neuroelectrophysiological monitoring
• evoked potentials