Transcranial Electrical Motor Evoked Potentials (tceMEP) in Anterior Cervical Discectomy and Fusion Surgery: A Comparison Study between Automated and Non-Automated Technologies

INTRODUCTION Spinal cord injury resulting in postoperative motor deficits is a serious complication of major spine surgery. Intraoperative electrophysiologic monitoring is performed to assess the functional integrity of the spinal cord in order to recognize and avoid injury. Motor pathways have been successfully monitored using transcranial electrical motor evoked potentials (tceMEP or MEP). A novel system offers automated intraoperative monitoring capabilities that utilize the “threshold-level” alert criteria method which provides more detailed myotome-specific responses, contrasted with the conventional “presence-or-absence” technique which uses a single supramaximal stimulus to obtain responses from one or all myotomes. The automated system then displays this feedback to the end user in a simplified form. The purpose of this study was to compare the automated system to that of conventional, nonautomated technology.