Do Intraoperative Neurophysiological Changes During Decompressive Surgery for Cervical Myeloradiculopathy Affect...

Area of Science:

• Neurosurgery
• Spinal Surgery
• Neuromonitoring

Background:

• Cervical compressive myelopathy requires surgical intervention.
• Intraoperative neuromonitoring (IONM) is used to assess neural integrity during surgery.
• The impact of IONM positive changes on functional outcomes is not fully understood.

Purpose of the Study:

• To investigate the effect of IONM positive changes on functional outcomes after surgery for cervical compressive myelopathy.
• To determine if specific IONM changes predict postoperative functional status.

Main Methods:

• Prospective cohort study of 28 patients undergoing cervical spine surgery with IONM.
• Motor-evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs) were monitored.
• Positive IONM changes were defined as MEP latency decrease >10% or amplitude increase >50%.

Main Results:

• Nine patients (32.1%) exhibited improved MEPs.
• No significant difference in postoperative Nurick grade between groups.
• Statistically significant improvement in modified Japanese Orthopaedic Association (mJOA) scores in the positive IONM change group (P = .011).
• Positive correlation found between IONM changes and 6-month mJOA scores (r = 0.47, P = .01).

Conclusions:

• Positive changes in MEPs during IONM indicate improved functional recovery at 6 months postoperatively.
• IONM may serve as a valuable tool for predicting functional outcomes in cervical compressive myelopathy surgery.