Surgical neurology international · 2026
Early somatosensory evoked potential monitoring warnings during positioning for cervical laminoplasty in ossification of the posterior longitudinal ligament patients.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Inagaki Hiroshi
Аннотация
BACKGROUND: Neurological deterioration during cervical laminoplasty for ossification of the posterior longitudinal ligament (OPLL) remains a significant clinical concern. This study evaluated the utility of somatosensory evoked potential (SEP) monitoring initiated immediately after anesthetic induction as an early warning system during surgical positioning.
METHODS: We retrospectively reviewed 63 consecutive patients with cervical OPLL who underwent laminoplasty (2023-2026). SEP monitoring of all four limbs was initiated in the supine position after induction to establish the intraoperative baseline. Alarm thresholds were 70% (caution) and 50% or below (critical) of baseline amplitudes in any monitored limb. Neurological status was assessed using the modified Japanese Orthopaedic Association (mJOA) scale.
RESULTS: Positioning-related SEP deterioration occurred in 8 patients (12.7%); all were detected before skin incision, and resolved following positional correction (i.e., typically in the opposite direction). No patient developed a permanent neurological deficit. Transient C5 palsy occurred in two patients in the no-SEP-change group that resolved within 3 weeks. All patients demonstrated mJOA improvement at 3 months.
CONCLUSION: SEP monitoring detected significant changes during positioning for laminoplasty in 12.7% of OPLL patients, all of which resolved in a timely fashion.
METHODS: We retrospectively reviewed 63 consecutive patients with cervical OPLL who underwent laminoplasty (2023-2026). SEP monitoring of all four limbs was initiated in the supine position after induction to establish the intraoperative baseline. Alarm thresholds were 70% (caution) and 50% or below (critical) of baseline amplitudes in any monitored limb. Neurological status was assessed using the modified Japanese Orthopaedic Association (mJOA) scale.
RESULTS: Positioning-related SEP deterioration occurred in 8 patients (12.7%); all were detected before skin incision, and resolved following positional correction (i.e., typically in the opposite direction). No patient developed a permanent neurological deficit. Transient C5 palsy occurred in two patients in the no-SEP-change group that resolved within 3 weeks. All patients demonstrated mJOA improvement at 3 months.
CONCLUSION: SEP monitoring detected significant changes during positioning for laminoplasty in 12.7% of OPLL patients, all of which resolved in a timely fashion.