Success Rate of Obtaining Baseline Somatosensory & Motor Evoked Potentials in Consecutive Cranial and Spinal Surgeries (P3.178)

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Objective: To evaluate the current rates of obtaining SEP and MEP baselines. Background: Intraoperative monitoring (IOM) has been documented as an adjunctive technique used to minimize neurologic deficit during brain and spinal surgeries. IOM is predicated on the patient acting as an internal control, and that obtaining reliable baseline potentials is essential for effective monitoring. Previous studies reported success rates in MEP as low as 66.6[percnt] in the lower extremities and these rates are associated with preexisting neurologic deficits. Design/Methods: Chart review of consecutive cranial and spinal cases from January 2010-2011. SEP and MEP baselines were after initiation of general anesthesia and before skin incision. Anesthesia consisted of TIVA or TIVA with halogenated agents with less than 0.5 MAC. Outcome measures: Primary: Success rate in obtaining SEP and MEP in all subjects. Secondary: Rates by preoperative surgical diagnosis. Results: 695 cranial and spinal cases that required IOM were reviewed. Greater than 90.1[percnt] success rate in both SEP and MEP. For cranial surgeries the success was more than 93[percnt]. In spinal surgeries, a similar success rate was seen in deformity and degenerative cases. However, a decrease in success rate was noted in patients with either trauma or infection. Discussion: Our success rates were higher than previously reported. Success rates in spinal infection and spinal trauma cases were lower than previously reported; perhaps reflecting the disease process. Though preexisting deficits are associated with reduced success rate, preoperative diagnosis seems to serve as an indicator as well.

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