ReviewClinical neurophysiology practice2026
Diagnostic test accuracy meta-analysis of transcranial motor evoked potential monitoring for the prediction of postoperative neurological deficits in ossification of the posterior longitudinal ligament surgery.
Review in Clinical neurophysiology practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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Abstract
Objective: To quantify the diagnostic accuracy of transcranial motor evoked potential (TcMEP) monitoring for predicting postoperative neurological deficits in adults undergoing decompressive surgery exclusively for ossification of the posterior longitudinal ligament (OPLL), and to characterise heterogeneity sources. Methods: PubMed, Embase, and Cochrane were searched through January 2026. Studies were eligible if they reported extractable 2 × 2 contingency data for TcMEP monitoring in OPLL-exclusive cohorts (≥20 patients); quality was assessed with QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies). Sensitivity and specificity were pooled using random-effects models; a strong threshold effect (ρ = 0.91) precluded valid summary receiver operating characteristic (sROC) estimation. Publication bias was assessed by funnel plot regression. Results: Five studies (990 patients; deficit rate 6.9%) met eligibility. Pooled sensitivity was 54.8% (95% confidence interval [CI]: 28.8-78.5%) and specificity 90.0% (95% CI: 78.9-95.6%). Positive likelihood ratio (LR+) was 5.47; negative LR- 0.50; diagnostic odds ratio (DOR) 13.75 (95% CI: 7.11-26.59; I Conclusions: TcMEP monitoring in OPLL decompression yields pooled sensitivity 54.8%, specificity 90.0%, DOR 13.75 (I Significance: This is the first meta-analysis of TcMEP diagnostic accuracy in OPLL-exclusive surgical populations. The consistent DOR (I
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