Introduction. Somatosensory evoked potential (SSEP) monitoring allows for assessment of the spinal cord and susceptible structures during complex spinal surgery. It is well validated for the detection of potential neurological injury but little is known of surgeon's responses to an abnormal trace and its effect on neurological outcome. We aimed to investigate this in spinal deformity patients who are particularly vulnerable during their corrective surgery. Methods. Our institutional
Introduction. Evidence suggests that intra-operative spinal cord monitoring is sensitive and specific for detecting potential neurological injury. However, little is known about surgeons' responses to trace changes and the resultant neurological outcome. Objective. To examine the role of intra-operative somatosensory evoked potential (SSEP) monitoring in the prevention of neurological injury, specifically sensitivity and specificity, and whether the abnormalities were reversible. Methods. 2953 consecutive complex spine operations (male 36% female 64%, median age 25yrs) prospectively performed using spinal cord monitoring at a single institution (2005–2009). All traces and neurophysiological events were prospectively recorded by the
The aim of the study was to assess the validity of the new device [BREVIO] [AEND] [Level 2 evidence] in diagnosing carpal tunnel syndrome in the outpatient setting when used by personnel not trained previously in neurophysiologic methods. We prospectively compared the results from a portable handheld automated electroneurodiagnostic devices (AEND) the BREVIO with those from conventional nerve conduction studies. We calculated specificity and sensitivity. We also studied the limits of agreement and correlation between measured latencies. Patient satisfaction with new device was recorded. Twenty-seven participants (42 hands) were tested. The average age was 56.43 years (38-79). There were 16 females and 11 males. The sensitivity and specificity of the BREVIO as compared to conventional methods were 80% and 75% using distal motor latencies; using distal sensory latencies the sensitivity and specificity were 90% and 60% respectively. The limits of agreement between the sensory and motor latencies using Bland Altman plots were good. Similarly there was good correlation between values measured with the Pearson's correlation coefficient. The position of the baseline cursor was questionable in 19 hands. Repositioning the cursor reduced the number of false positive results which would increase the specificity of the device. The average pain score, VAS on a scale of 1-10, with the BREVIO was 1.69 (1-4) and 3.11(1-5) with conventional testing. The average satisfaction rating on a scale of 1-5 was 1.39 with the BREVIO and 2.73 with the conventional nerve conduction testing. The BREVIO is an interesting device. We recommend its use by untrained persons only under the supervision of someone trained in