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INTRAOPERATIVE NEUROPHYSIOLOGICAL MONITORING IN SPINE SURGERY: CHARACTERIZATION OF MEP PATTERNS AND ANALYSIS OF MOTOR OUTCOME IN 19 CASES
Gabriel Barreiros Lapetina Andrade Santanaand 1 co-author
Lusíada University Center (UNILUS)
FENS Forum 2026 (2026)
Barcelona, Spain
Board PS06-09PM-580
Presentation
Date TBA
Board: PS06-09PM-580
Event Information
Poster Board
PS06-09PM-580
Poster
View posterAbstract
Intraoperative neurophysiological monitoring (IONM) is used in spine surgery to assess, in real time, the functional integrity of motor and sensory pathways to support clinical decisions during critical intraoperative events. This study aimed to characterize patterns of motor evoked potentials (MEPs) during spine surgery and to correlate them with postoperative motor outcomes.1,3,5,6
A retrospective case series (2023–2024) was conducted including 19 spine surgeries (cervical, thoracic, lumbar, or thoracolumbar) performed with multimodal IONM, incorporating MEPs, somatosensory evoked potentials (SSEPs), and electromyography (EMG) when available. Baseline recordings were obtained after anesthetic induction. Final intraoperative MEP behavior relative to baseline was classified as maintained, improved, or persistently decreased. The primary clinical outcome was new postoperative motor deficit. 1,3
MEPs remained stable in 13/19 cases (68.4%) and improved intraoperatively in 5/19 (26.3%), often following decompressive steps. In 1/19 case (5.3%), a persistent MEP loss predominantly affecting S1-related muscles bilaterally occurred after pedicle screw placement, with no meaningful recovery 5 minutes after sugammadex administration and no clinical motor deterioration. No patient developed a new postoperative motor deficit (0/19). These findings describe three practical intraoperative MEP patterns in spine surgery and reinforce the role of IONM as a dynamic functional assessment tool to support intraoperative decision-making. Larger studies may further refine the relationship between intraoperative MEP changes and neurological outcomes.1,2,6
A retrospective case series (2023–2024) was conducted including 19 spine surgeries (cervical, thoracic, lumbar, or thoracolumbar) performed with multimodal IONM, incorporating MEPs, somatosensory evoked potentials (SSEPs), and electromyography (EMG) when available. Baseline recordings were obtained after anesthetic induction. Final intraoperative MEP behavior relative to baseline was classified as maintained, improved, or persistently decreased. The primary clinical outcome was new postoperative motor deficit. 1,3
MEPs remained stable in 13/19 cases (68.4%) and improved intraoperatively in 5/19 (26.3%), often following decompressive steps. In 1/19 case (5.3%), a persistent MEP loss predominantly affecting S1-related muscles bilaterally occurred after pedicle screw placement, with no meaningful recovery 5 minutes after sugammadex administration and no clinical motor deterioration. No patient developed a new postoperative motor deficit (0/19). These findings describe three practical intraoperative MEP patterns in spine surgery and reinforce the role of IONM as a dynamic functional assessment tool to support intraoperative decision-making. Larger studies may further refine the relationship between intraoperative MEP changes and neurological outcomes.1,2,6
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