Final Thesis IONM Masterchart (1).xlsx

<b>Abstract</b><br><b>Introduction: </b>Neurophysiological monitoring practiced as a diagnostic modality to determine intra-operative neural damage. There remains great lacuna of significant research underlining its therapeutic role in terms of determining and modifying patient’s motor or sensory improvement.<br><b>Aim: </b>To study the role of Intraoperative neurophysiological changes by means of SSEP (somatosensory evoked potential) and MEP (Motor evoked potential) in spinal surgery cases and its use as a determinant of post-operative outcome.<br><b>Methodology: </b>A prospective observational study. Patients undergoing spine surgeries, irrespective of their aetiology and procedure, were monitored using MEP and SSEP. Groups were made based on changes in intraoperative neuromonitoring graph. Outcome was observed by clinical assessment, in immediate post-operative phase (after 48 hr) and after 6 months.<br><b>Results: </b>Patients who had transient MEP decline had no post-operative deficits. On the contrary, these patients along with the cases with no MEP change or improved MEP trace from baseline, had improvement from baseline motor examination. Of the 9 patients, showing permanent MEP decrease, 8 had post-operative motor deficits. Similarly, 3 patients had intraoperative SSEP decline, of whom 1 had post-operative sensory deficit. In 38 patients, there was improvement in MEP/SSEP from baseline reading intra-operatively, showing clinical improvement too.<br><b>Conclusion: </b>Along with supporting the hypothesis of therapeutic benefits of IONM by predicting post-operative outcome and thereby preventing clinical deficit, this study also suggests about the higher sensitivity and specificity of MEP as compared to SSEP in spine surgery cases.