Intraoperative Baseline Motor Signals as a Predictor of Recovery in Complete Spinal Cord Injury

Area of Science:

• Neurosurgery
• Neurology
• Spinal Cord Injury Research

Background:

• Complete spinal cord injury (SCI) presents challenges in predicting patient recovery.
• Baseline intraoperative sensory and motor signals may indicate intact neuronal tracts.
• These signals could serve as prognostic indicators for functional improvement.

Purpose of the Study:

• To investigate the association between baseline intraoperative neuromonitoring and functional improvement in complete SCI.
• To determine the prognostic value of specific intraoperative signals for recovery outcomes.

Main Methods:

• Retrospective observational study of 119 complete SCI patients undergoing decompression.
• Assessed baseline intraoperative neuromonitoring, including motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs).
• Analyzed functional improvement using ASIA scores, considering grade conversions and level improvements, with logistic regression.

Main Results:

• Approximately 32% of patients demonstrated functional improvement.
• MEPs were present at the injury level in 17.2% and above the injury in 49.2% of patients.
• MEPs present at the level of injury were the sole significant predictor of functional improvement (OR=3.14, P=0.023).

Conclusions:

• Intraoperative motor signals at the injury level show prognostic value in complete SCI.
• These findings are vital for predicting patient outcomes post-surgery.
• This information can guide future management and clinical decision-making for SCI patients.