Predictive value of intraoperative neurophysiologic monitoring in detecting new postoperative neurological deficits

Solapas principales

Pérez P.1., Quintanilla B.2., Alvarez L.3., Mejía M.2.

 

ABSTRACT:

            Intraoperative neurophysiological monitoring (IONM) in most of the studies has shown that it can detect and prevent new neurological deficit again (NND) with reasonable sensitivity and specificity.

A prospective study of 16 patients undergoing neurosurgical procedures, applying standardized protocols IONM, classifying them into groups of predictability values ​​according to the neurophysiological events were found.

The mean age was 36.7 + / -21.8 years, 68.8% of injuries were infratentorial brain tumor, the rest to the cervical spinal cord of which, 18.7% were extramedullary and 12.5% ​​intramedullary. Of the 4 patients with NND, 3 were detected with IONM, and 1 case was a false negative, having a sensitivity of 75%, the negative predictive value was 83.3%, the positive predictive value was 80%, and specificity of 71.4%.

One should consider in the analysis of the effectiveness of neurophysiological monitoring, not only changes in evoked potentials (EPs) and postoperative condition of the patient, but also measures followed a deterioration of Pes, to help prevent neurological deterioration patient that occurs in the majority of cases in which the surgeon reacts to neurophysiological alarm event.

 

 

Key Words: Predictive value, intraoperative monitoring, neurological deficit, sensitivity specificity.

 

 


  1. Servicio de Neurofisiología, Hospital Miguel Grau – EsSalud, Lima – Perú
  2. Departamento Neurocirugía, Hospital Guillermo Almenara – EsSalud, Lima – Perú
  3. Departamento Neurocirugía, Hospital Edgardo Rebagliati – EsSalud, Lima – Perú

 

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