ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2021
Feasibility and diagnostic accuracy of intra-operative monitoring of motor evoked potentials in children <2 years of age undergoing tethered cord surgery: results in 100 children.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 7 citations in OpenAlex.
- Microsurgical Untethering of Pediatric Lipomyelomeningocele: A Stepwise, Photo-Illustrated Technical Note.Brain sciences · 2026Article
- Threshold-guided optimization of transcranial electrical stimulation parameters for motor evoked potential monitoring in pediatric spinal surgery.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Correlating postoperative muscle and long-term functional outcomes with intraoperative muscle motor evoked potential changes in patients with benign intramedullary spinal cord tumors.Acta neurochirurgica · 2025Article
- Transcranial electrical evoked muscle potentials for pediatric neurosurgery: scoping review of stimulation techniques and success rates.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Article
- Pre-operative clinical deterioration and long-term surgical outcomes in 41 patients with split cord malformation type 1.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
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5 authors at 1 institution in 1 country.
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Abstract
objectiveThis study documents the monitorability using different anesthesia regimes and accuracy of muscle motor evoked potentials (mMEPs) in children ≤2 years of age undergoing tethered cord surgery (TCS).
methodsIntraoperative mMEP monitoring was attempted in 100 consecutive children, ≤2 years of age, undergoing TCS. MEP monitoring was done under 4 different anesthetic regimes: (Total intravenous anesthesia (TIVA); balanced anesthesia with sevoflurane and ketamine; balanced anesthesia with isoflurane and ketamine; and balanced anesthesia with sevoflurane). Factors analyzed for their effect on monitorability were: age, neurological deficits, type of anesthesia, and the number of pulses used for stimulation.
resultsBaseline mMEPs were obtained in 87% children. Monitorability of mMEPs was similar in children ≤1 year and 1-2 years of age (85.7% and 87.5%). In multivariate analysis, anesthesia regime was the only significant factor predicting presence of baseline mMEPs. Children undergoing TIVA (p=0.02) or balanced anesthesia with a combination of propofol, sevoflurane, and ketamine (p=0.05) were most likely to have baseline mMEPs. mMEPs had a sensitivity of 97.4%, specificity of 96.4%, negative predictive value of 98.2% and accuracy of 96.8%.
conclusionsBaseline mMEPs were obtained in >85% of children ≤2 years of age including those who had motor deficits. TIVA and balanced anesthesia with sevoflurane and ketamine are ideal for mMEP monitoring. mMEPs have a high accuracy although, false positive and false negative results can occasionally be experienced.
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