Study on the neurological prognosis of patients who have undergone spinal surgery with intraoperative neurophysiological monitoring in Republic of Korea: a retrospective single center study
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Background: The purpose of this study was to determine how intraoperative neurophysiological monitoring (IONM) affects the neurological prognosis of patients based on the data from outcomes of various spinal surgeries.Methods: A retrospective cohort study was conducted by reviewing the medical records of 175 patients who underwent spinal surgery using IONM from March 2017 to February 2022 at the Dankook University Hospital. These patients were divided into two groups, namely IONM-alarmed patients and non-alarmed patients. Their neurological prognosis was compared based on their Medical Research Council (MRC) grade, the length of hospital stay in days, the neuropathic pain scale, and the American Spinal Cord Injury Association (ASIA) scale. The MRC grade, neuropathic pain scale, and ASIA scale were compared using the chi-squared test. The length of hospital stay in days was compared using the Kaplan–Meier survival analysis.Results: There was no statistical relationship between the MRC grade and the results of the IONM (p = 0.364). However, survival analysis of the two groups showed a meaningful difference (p = 0.047). The average hospital stay in days was 9.734 ± 0.443 for the non-alarmed group and 13.278 ± 1.834 days for the alarmed group.Conclusion: IONM during spinal surgery did not result in a significant difference between the alarm signs of IONM and the muscle strength grade of the patients in the short term. However, this study showed that the IONM can shorten the length of hospital stay in days related to returning to daily living.
Abstract
Background: The purpose of this study was to determine how intraoperative neurophysiological monitoring (IONM) affects the neurological prognosis of patients based on the data from outcomes of various spinal surgeries.Methods: A retrospective cohort study was conducted by reviewing the medical records of 175 patients who underwent spinal surgery using IONM from March 2017 to February 2022 at the Dankook University Hospital. These patients were divided into two groups, namely IONM-alarmed patients and non-alarmed patients. Their neurological prognosis was compared based on their Medical Research Council (MRC) grade, the length of hospital stay in days, the neuropathic pain scale, and the American Spinal Cord Injury Association (ASIA) scale. The MRC grade, neuropathic pain scale, and ASIA scale were compared using the chi-squared test. The length of hospital stay in days was compared using the Kaplan–Meier survival analysis.Results: There was no statistical relationship between the MRC grade and the results of the IONM (p = 0.364). However, survival analysis of the two groups showed a meaningful difference (p = 0.047). The average hospital stay in days was 9.734 ± 0.443 for the non-alarmed group and 13.278 ± 1.834 days for the alarmed group.Conclusion: IONM during spinal surgery did not result in a significant difference between the alarm signs of IONM and the muscle strength grade of the patients in the short term. However, this study showed that the IONM can shorten the length of hospital stay in days related to returning to daily living.
참고문헌 (16)
- Korean Society of Intraoperative Neurophysiological Monitoring, "Clinical practice guideline for intraoperative neurophysiological monitoring : 2020 update", J Intraoper Neurophysiol, 2, pp.1~10 (2020)
- Kim JS, "Intraoperative neurophysiologic monitoring in the spine surgery", J Intraoper Neurophysiol, 1, pp.1~14 (2019)
- Kim SM, "Guidelines for neurophysiologic procedures", pp.133~169 (2021), Jin Publishing and Communication
- Nasser R, "Complications in spine surgery", J Neurosurg Spine, 13, pp.144~157 (2010)
- Sutter M, "The diagnostic value of multimodal intraoperative monitoring(MIOM)during spine surgery : a prospective study of 1, 017 patients", Eur Spine J, 16(Suppl 2), pp.S162~S170 (2007)
- Epstein NE, "More risks and complications for elective spine surgery in morbidly obese patients", Surg Neurol Int, 8, pp.66~ (2017)
- Gunnarsson T, "Real-time continuous intraoperative electromyographic and somatosensory evoked potential recordings in spinal surgery : correlation of clinical and electrophysiologic findings in a prospective, consecutive series of 213 cases", Spine(Phila Pa 1976), 29, pp.677~684 (2004)
- Asai T, "Sexand age-related differences in spinal degeneration : an anatomical and magnetic resonance imaging study of the human spine", Prog Rehabil Med, 7, pp.20220011~ (2022)
- Ropper AH, "Adams and victor's principles of neurology", pp.1225~1275 (2023), McGraw Hill
- Hansson P, "Usefulness and limitations of quantitative sensory testing : clinical and research application in neuropathic pain states", Pain, 129, pp.256~259 (2007)
- Sala F, "Surgery for intramedullary spinal cord tumors : the role of intraoperative(neurophysiological)monitoring", Eur Spine J, 16(Suppl 2), pp.S130~S139 (2007)
- Sala F, "Motor evoked potential monitoring improves outcome after surgery for intramedullary spinal cord tumors : a historical control study", Neurosurgery, 58, pp.1129~1143 (2006)
- Lee KS, "Transient paraparesis after laminectomy in a patient with multi-level ossification of the spinal ligament", J Korean Med Sci, 19, pp.624~626 (2004)
- Zhang JD, "Transient paralysis shortly after anterior cervical corpectomy and fusion", Orthop Surg, 5, pp.23~28 (2013)
- Fehlings MG, "The evidence for intraoperative neurophysiological monitoring in spine surgery : does it make a difference?", Spine(Phila Pa 1976), 35(9 Suppl), pp.S37~S46 (2010)
- Howick J, "Foundations for evidence-based intraoperative neurophysiological monitoring", Clin Neurophysiol, 127, pp.81~90 (2016)
