Sensitivity and specificity of somatosensory and neurogenic-motor evoked potentials in animals and humans

The purpose of this study was to report the effects of spinal cord compression, ischemia, and distraction on clinical status, and somatosensory (SEP) and neurogenic-motor evoked potentials (NMEPs) in animals. The authors also reported their clinical experience with NMEPs elicited from humans undergoing surgery for spinal deformities. Results from the animal studies indicate that NMEPs are more sensitive and specific to the effects from spinal cord compression, ischemia, and distraction than SEPs. In every situation, NMEPs always correlated with the animal's post-surgical clinical status, while SEPs demonstrated an unacceptable false positive and false negative rate. In the 111 clinical cases in which NMEPs were administered, reliable NMEPs were easily elicited in more than 90% of the cases. In the remaining cases, no reliable NMEPs could be recorded because of procedural errors, which have been resolved. The results from this study suggest that the use of NMEPs should be considered as an adjunct to SEPs when monitoring spinal cord function during surgery.