Intraoperative MEP and EMG during the wake-up phase as adjuncts to the wake-up test in severe spinal deformity surgery

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The study evaluated the value of intraoperative motor evoked potential (MEP) recovery and electromyography (EMG) during the wake-up phase.
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A retrospective analysis included 111 patients with intraoperative MEP alerts who underwent thoracic osteotomy for severe spinal deformity.
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The false-positive rate for predicting complete paralysis was lowest when combining wake-up test, MEP, and EMG findings.
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MEP and EMG responses were obtained earlier during arousal than direct wake-up test responses in patients without complete paralysis.
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The findings suggest that MEP recovery and EMG activity may complement the traditional wake-up test in assessing neurological risk.

Frontiers In Surgery

by Birong Gao, Yaolong Deng, Jian Chen, Juncheng Li, Jingfan Yang, Junlin Yang, Yaqing Zhang
June 18, 2026

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