• Daniel M Schwartz, Anthony K Sestokas, John P Dormans, Alexander R Vaccaro, Alan S Hilibrand, John M Flynn, P Mark Li, Suken A Shah, William Welch, Denis S Drummond, and Todd J Albert.
• Surgical Monitoring Associates, Springfield, PA 19064, USA. dan@surgmon.com
• Spine. 2011 Jun 1; 36 (13): 1046-9.

Study DesignRetrospective review.ObjectiveTo report on the safety of repetitive transcranial electric stimulation (RTES) for eliciting motor-evoked potentials during spine surgery.Summary Of Background DataTheoretical concerns over the safety of RTES have hindered broader acceptance of transcranial electric motor-evoked potentials (tceMEP), despite successful implementation of spinal cord monitoring with tceMEPs in many large spine centers, as well as their apparent superiority over mixed-nerve somatosensory-evoked potentials (SSEP) for detection of spinal cord injury.MethodsThe records of 18,862 consecutive patients who met inclusion criteria and underwent spine surgery with tceMEP monitoring were reviewed for RTES-related complications.ResultsThis large retrospective review identified only 26 (0.14%) cases with RTES-related complications; all but one of these were tongue lacerations, most of which were self-limiting.ConclusionsThe results demonstrate that RTES is a highly safe modality for monitoring spinal cord motor tract function intraoperatively.

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