For a study, the researchers aimed to conclude the diagnostic accuracy of intraoperative lower extremity SSEP changes for predicting postoperative neurological deficit. As a secondary examination, evaluation of 3 subtypes of intraoperative SSEP changes: reversible, irreversible, and total signal loss were done. A systematic review was conducted to identify study with outcomes of patients who underwent lumbar spine surgeries with intraoperative SSEP monitoring. The sensitivity, specificity, and diagnostic odds ratio (DOR) were examined and presented with forest plots and a summarized receiver operating characteristic curve. The study cohort included 5,607 patients. All important intraoperative SSEP changes had a sensitivity of 44% and specificity of 97% with a DOR of 22.13 (95% CI,11.30–43.34). Reversible and irreversible SSEP changes have sensitivities of 28% and 33% and specificities of 97% and 97%, respectively. The DORs for reversible and irreversible SSEP changes were 13.93 (95% CI, 4.60–40.44) and 57.84 (95% CI,15.95–209.84), respectively. Total loss of SSEPs was found to have a sensitivity of 9% and specificity of 99% with a DOR of 23.91 (95% CI,7.18–79.65). SSEP changes during lumbar spine surgery were found to be highly specific but moderately sensitive for new postoperative neurological deficits. Patients who suffered from postoperative neurological deficit were 22 times more likely to have exhibited intraoperative SSEP changes.
