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Prognosticating study for cervical myelopathy using evoked spinal cord potentials.

K Shinomiya¹, A Okamoto, H Komori

¹Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.

|October 1, 1990

Summary

Evoked spinal cord potentials (ESCP) predict surgical outcomes for cervical spondylotic myelopathy and OPLL. Localized lesions identified by ESCP correlate with excellent postoperative results, unlike extensive lesions.

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Area of Science:

Neurosurgery
Neurology
Spinal Cord Medicine

Background:

Cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) are major causes of spinal cord compression.
Surgical intervention is common for these conditions, but predicting postoperative outcomes remains challenging.

Observation:

This study analyzed 123 patients with CSM and OPLL undergoing surgery, utilizing evoked spinal cord potentials (ESCP) to assess neurological function.
Key electrophysiological indicators for poor outcomes included the disappearance or positive wave changes in ESCP at the lesion site and slow conduction velocity (<40 m/s).

Findings:

Localized spinal cord lesions, identified via ESCP, were associated with significantly better surgical outcomes compared to extensive lesions.
A higher prevalence of extensive lesions was observed in OPLL (54%) compared to CSM (14%).

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Approximately 76% of the studied cases presented with localized lesions, while 24% had extensive lesions.

Implications:

ESCP serve as a valuable tool for prognostication in patients with CSM and OPLL, aiding in surgical planning and patient counseling.
The findings highlight the importance of lesion extent, as determined by ESCP, in predicting functional recovery after surgery.
Differentiating between localized and extensive lesions preoperatively can help manage patient expectations regarding surgical results.