Dermatomal somatosensory evoked potentials and cortical somatosensory evoked potentials assessment in congenital scoliosis

Zhenxing Zhang; Yi Wang; Tao Luo; Huaguang Qi; Lin Cai; Yang Yuan; Jingfeng Li

doi:10.1186/s12883-022-02579-4

Dermatomal somatosensory evoked potentials and cortical somatosensory evoked potentials assessment in congenital scoliosis

BMC Neurol. 2022 Feb 15;22(1):58. doi: 10.1186/s12883-022-02579-4.

Authors

Zhenxing Zhang^#¹, Yi Wang^#², Tao Luo^#², Huaguang Qi³, Lin Cai¹, Yang Yuan⁴, Jingfeng Li⁵

Affiliations

¹ Department of neurospinal, Xi'an HongHui Hospital Affiliated of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
² Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
³ Department of Functional Examinantion, Xi'an HongHui Hospital Affiliated of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
⁴ Department of Functional Examinantion, Xi'an HongHui Hospital Affiliated of Xi'an Jiaotong University, Xi'an, Shaanxi, China. 250229908@qq.com.
⁵ Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China. jingfengli@whu.edu.cn.

^# Contributed equally.

Abstract

Background: The aim of this study was to assess the value of dermatomal somatosensory evoked potentials (DSEPs) and cortical somatosensory evoked potentials (SSEPs) in monitoring spinal cord function for patients with congenital scoliosis (CS).

Methods: This retrospective study reviewed the medical records of patients (n = 102) who underwent DSEP (T2-S1 dermatome), of whom 60 were normal subjects and 62 with congenital scoliosis. The study analyzed the latencies and peaks of N1-L, N1-R, P1-L and P1-R recorded by DSEPs of patients' thoracolumbar dermatomes. To observe the incidence of abnormal DSEPs and SSEPs in CS patients and to analyze the difference in sensitivity and reliability between the two in the examination of scoliosis patients. SPSS 22.0 statistical software package was used to analyze the data, and χ2 test and correlation analysis were used to indicate that the difference was statistically significant, p < 0.05.

Results: Sixty two patients with CS were evaluated with total spine magnetic resonance imaging (MRI). Only 23 patients (37.09%) showed spinal cord malformations in the MRI findings. The DSEP recordings showed a relatively high sensitivity (97.8%) compared to the abnormality rate of SSEPs recordings, and the rates of waveform, latency and amplitude abnormalities were much higher in DSEPs recordings (36.6, 36.3, 24.8%) than in SSEPs recordings (3.2, 22.5, 14.5%). The abnormality rate of DSEP records with and without neurological symptoms was higher than the abnormality rate of SSEP records (100% vs 20, 96.2% vs 44.2%, p<0.05). And in 62 patients with CS, the rate of positive MRI (37.1%) was lower than that recorded by DSEP (79.6% / 57.9%). p < 0.05.

Conclusion: DSEPs are more sensitive to microscopic posterior column dysfunction in patients with CS that cannot be detected by either radiology or routine clinical examination. Preoperative DSEPs assessment is recommended as a baseline examination for intraoperative monitoring and comparison with the postoperative situation. DSEPs recording complements the information obtained from routine clinical and radiological evaluation.

Keywords: Congenital scoliosis; Cortical somatosensory evoked potentials (SSEPs); Dermatomal somatosensory evoked potentials (DSEPs); Sensitivity.

MeSH terms

Evoked Potentials, Somatosensory
Humans
Reproducibility of Results
Retrospective Studies
Scoliosis* / diagnostic imaging
Spinal Nerve Roots