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Published on: August 16, 2021
Transcranial magnetic stimulation screening for cord compression in cervical spondylosis
1Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore 169608, Singapore. gnrlyl@sgh.com.sg
Objective:
Cervical spondylosis (CS) often results in various degrees of cord compression, which can be evaluated functionally with transcranial magnetic stimulation (TMS). We investigate the use of TMS as a screening tool for myelopathy in CS.
Methods:
We prospectively studied 231 patients classified into Groups 1 to 4 based on MRI grading of severity of cord compromise. TMS elicited central motor conduction times and motor evoked potential (MEP) amplitudes in all 4 limbs. The results were compared with those from 45 healthy controls.
Results:
TMS showed 98% sensitivity and 98% specificity for cord abnormality using MRI as reference standard.
Conclusions:
MEP abnormalities are useful for electrophysiological evaluation of cord compression in CS. While TMS is not a substitute for MRI, it is of value as a rapid, inexpensive and non-invasive technique for screening patients before MRI studies.
