ArticleGlobal spine journal2025
Impact of Preoperative Motor Status for the Positive Predictive Value of Transcranial Motor-Evoked Potentials Alerts in Thoracic Spine Surgery: A Prospective Multicenter Study by the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research.
Article in Global spine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
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Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 2 citations in OpenAlex.
- Comparative diagnostic performance of motor-evoked potential alarm thresholds for predicting postoperative neurological decline in intradural extramedullary spinal tumor surgery: a systematic review and meta-analysis.Neurosurgical review · 2026Pooled it
- Accuracy of intraoperative neurophysiological monitoring in predicting postoperative neurological decline in intradural extramedullary spinal tumor surgery: a systematic review and meta-analysis.Neurosurgical review · 2025Pooled it
- Low baseline Tc-MEP amplitude is associated with false-positive alerts in spine surgery: a ROC-based analysis across spinal pathologies.Journal of clinical monitoring and computing · 2026Article
- Intraoperative Neurophysiological Monitoring in Neurosurgery.Journal of clinical medicine · 2024Review
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Authors and funding
29 authors at 18 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designProspective multicenter study.
objectiveTo investigate the validity of transcranial motor-evoked potentials (Tc-MEP) in thoracic spine surgery and evaluate the impact of specific factors associated with positive predictive value (PPV).
methodsOne thousand hundred and fifty-six cases of thoracic spine surgeries were examined by comparing patient backgrounds, disease type, preoperative motor status, and Tc-MEP alert timing. Tc-MEP alerts were defined as an amplitude decrease of more than 70% from the baseline waveform. Factors were compared according to preoperative motor status and the result of Tc-MEP alerts. Factors that showed significant differences were identified by univariate and multivariate analysis.
resultsOverall sensitivity was 91.9% and specificity was 88.4%. The PPV was significantly higher in the preoperative motor deficits group than in the preoperative no-motor deficits group for both high-risk (60.3% vs 38.3%) and non-high-risk surgery groups (35.1% vs 12.8%). In multivariate logistic analysis, the significant factors associated with true positive were surgical maneuvers related to ossification of the posterior longitudinal ligament (odds ratio = 11.88; 95% CI: 3.17-44.55), resection of intradural intramedullary spinal cord tumor (odds ratio = 8.83; 95% CI: 2.89-27), preoperative motor deficit (odds ratio = 3.46; 95% CI: 1.64-7.3) and resection of intradural extramedullary spinal cord tumor (odds ratio = 3.0; 95% CI: 1.16-7.8). The significant factor associated with false positive was non-attributable alerts (odds ratio = .28; 95% CI: .09-.85).
conclusionSurgeons are strongly encouraged to use Tc-MEP in patients with preoperative motor deficits, regardless of whether they are undergoing high-risk spine surgery or not. Knowledge of PPV characteristics will greatly assist in effective Tc-MEP enforcement and minimize neurological complications with appropriate interventions.
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