Feasibility of adjunct facial motor evoked potential monitoring to reduce the number of false-positive results during cervical spine surgery.

• Material Type: 博士論文
• Title: Feasibility of adjunct facial motor evoked potential monitoring to reduce the number of false-positive results during cervical spine surgery.
• Author/Editor: Matsuoka, Ryuta; Takeshima, Yasuhiro; Hayashi, Hironobu; Takatani, Tsunenori; Nishimura, Fumihiko; Nakagawa, Ichiro; Motoyama, Yasushi; Park, Young-Su; Kawaguchi, Masahiko; Nakase, Hiroyuki
• Author Heading: Matsuoka, Ryuta; Takeshima, Yasuhiro; Hayashi, Hironobu; Takatani, Tsunenori; Nishimura, Fumihiko; Nakagawa, Ichiro; Motoyama, Yasushi; Park, Young-Su; Kawaguchi, Masahiko; Nakase, Hiroyuki
• Publication, Distribution, etc.: American Association of Neurological Surgeons
• Publication Date: 2019-12
• Publication Date (W3CDTF): 2019-12
• Alternative Title: 頚椎手術術中神経モニタリングにおける偽陽性減少を目的とした顔面運動誘発電位の応用
• Periodical title: Journal of neurosurgery. Spine
• No. or year of volume/issue: 32 4
• Volume: 32
• Issue: 4
• Pages: 570-577
• ISSN (Periodical Title): ISSN : 1547-5654
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2020-06-30
• Dissertation Number: 甲第746号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: cervical spine; control; facial nerve; false-positive; intraoperative neuromonitoring; motor evoked potential
• Target Audience: 一般
• Note (General): type:Thesis; Objective: False-positive intraoperative muscle motor evoked potential (mMEP) monitoring results due to systemic effects of anesthetics and physiological changes continue to be a challenging issue. Although control MEPs recorded from the unaffected side are useful for identifying a true-positive signal, there are no muscles on the upper or lower extremities to induce control MEPs in cervical spine surgery. Therefore, this study was conducted to clarify if additional MEPs derived from facial muscles can feasibly serve as controls to reduce false-positive mMEP monitoring results in cervical spine surgery. Methods: Patients who underwent cervical spine surgery at the authors' institution who did not experience postoperative neurological deterioration were retrospectively studied. mMEPs were induced with transcranial supramaximal stimulation. Facial MEPs (fMEPs) were subsequently induced with suprathreshold stimulation. The mMEP and subsequently recorded fMEP waveforms were paired during each moment during surgery. The initial pair was regarded as the baseline. A significant decline in mMEP and fMEP amplitude was defined as > 80% and > 50% decline compared with baseline, respectively. All mMEP alarms were considered false positives. Based on 2 different alarm criteria, either mMEP alone or both mMEP and fMEP, rates of false-positive mMEP monitoring results were calculated. Results: Twenty-three patients were included in this study, corresponding to 102 pairs of mMEPs and fMEPs. This included 23 initial and 79 subsequent pairs. Based on the alarm criterion of mMEP alone, 17 false-positive results (21.5%) were observed. Based on the alarm criterion of both mMEP and fMEP, 5 false-positive results (6.3%) were observed, which was significantly different compared to mMEP alone (difference 15.2%; 95% CI 7.2%-23.1%; p < 0.01). Conclusions: fMEPs might be used as controls to reduce false-positive mMEP monitoring results in cervical spine surgery.; 博士（医学）・甲第746号・令和2年6月30日; © Copyright 2019 American Association of Neurological Surgeons; The definitive version is available at " http://dx.doi.org/10.3171/2019.9.SPINE19800 "; identifier:Journal of neurosurgery. Spine Vol.32 No.4 p.570-577 (2019 Dec); identifier:15475654; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3753; identifier:Journal of neurosurgery. Spine, 32(4): 570-577
• Source: fulltext; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3753/1/01%e7%94%b2746%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3753/2/02%e7%94%b2746%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3753/6/03%e7%94%b2746%e6%9c%ac%e6%96%87.pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.3171/2019.9.SPINE19800
• Periodical Title (NCID): AA11357949; https://ci.nii.ac.jp/ncid/AA11357949
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU