Diagnostic and prognostic significance of preoperative evoked potential tests in degenerative cervical myelopathy
•Surgical decisions for degenerative cervical myelopathy (DCM) primarily depend on clinical symptoms and radiological examinations. Preoperative evoked potential testing is a functional diagnostic tool that can indicate the severity of myelopathic symptoms in patients with DCM. Additionally, preoper...
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| Veröffentlicht in: | The spine journal 2024-01, Vol.24 (1), p.87-93 |
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| description | •Surgical decisions for degenerative cervical myelopathy (DCM) primarily depend on clinical symptoms and radiological examinations. Preoperative evoked potential testing is a functional diagnostic tool that can indicate the severity of myelopathic symptoms in patients with DCM. Additionally, preoperative tibial nerve-somatosensory evoked potential has significant prognostic value in predicting postoperative clinical outcomes. Thus, preoperative evoked potential tests are significantly helpful in determining suitable surgical treatment and forecasting postoperative prognosis.
Decompression surgery is a treatment option for patients with degenerative cervical myelopathy (DCM). Surgical decisions primarily depend on clinical symptoms and radiological examinations. The diagnostic and prognostic significance of evoked potential tests for surgical outcomes in patients with DCM has not been thoroughly examined.
To identify the diagnostic and prognostic significance of preoperative evoked potential tests in patients with DCM who underwent decompression surgery.
This was a retrospective observational study.
One hundred two consecutive patients who underwent evoked potential tests and surgical treatment between January 2016 and December 2020 in a single spine center and had a minimum follow-up of 6 months.
Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
This study evaluated the preoperative central motor conduction time (CMCT), somatosensory evoked potentials, and Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
Abnormal CMCT findings were observed in 94 patients (92.2%). Abnormal somatosensory evoked potentials were observed in 77 patients (75.5%). There was a statistically significant correlation between preoperative JOA score and abductor pollicis brevis (APB)-CMCT (r=−0.546, p=.001), tibialis anterior (TA)-CMCT (r=−0.517, p |
| doi_str_mv | 10.1016/j.spinee.2023.09.006 |
| format | Article |
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Decompression surgery is a treatment option for patients with degenerative cervical myelopathy (DCM). Surgical decisions primarily depend on clinical symptoms and radiological examinations. The diagnostic and prognostic significance of evoked potential tests for surgical outcomes in patients with DCM has not been thoroughly examined.
To identify the diagnostic and prognostic significance of preoperative evoked potential tests in patients with DCM who underwent decompression surgery.
This was a retrospective observational study.
One hundred two consecutive patients who underwent evoked potential tests and surgical treatment between January 2016 and December 2020 in a single spine center and had a minimum follow-up of 6 months.
Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
This study evaluated the preoperative central motor conduction time (CMCT), somatosensory evoked potentials, and Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
Abnormal CMCT findings were observed in 94 patients (92.2%). Abnormal somatosensory evoked potentials were observed in 77 patients (75.5%). There was a statistically significant correlation between preoperative JOA score and abductor pollicis brevis (APB)-CMCT (r=−0.546, p=.001), tibialis anterior (TA)-CMCT (r=−0.517, p<.001), median nerve (MN)-SSEP (r=−0.353, p=.001), and tibial nerve (TN)-SSEP (r=−0.349, p=.003). There were significant differences in recovery rates associated with diabetes mellitus (DM), preoperative severity of myelopathy, TA-CMCT, MN-SSEP, and TN-SSEP. Stepwise multiple regression analysis showed that the major factors affecting the clinical outcomes were TN-SSEP (β=0.327, p=.004), preoperative JOA score (β=0.278, p=.012), and DM (β=0.241, p=.025).
Evoked potential testing is a functional diagnostic tool that can indicate the severity of myelopathic symptoms in patients with DCM. Additionally, preoperative TN-SSEP may have significant prognostic value in predicting postoperative clinical outcomes. Thus, preoperative evoked potential tests could be helpful for determining suitable surgical treatment candidates and forecasting postoperative prognosis.</description><identifier>ISSN: 1529-9430</identifier><identifier>EISSN: 1878-1632</identifier><identifier>DOI: 10.1016/j.spinee.2023.09.006</identifier><identifier>PMID: 37704047</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cervical Vertebrae - surgery ; Compressive myelopathy ; Diagnosis ; Evoked potentials ; Evoked Potentials, Somatosensory ; Humans ; Prognosis ; Prognostic factors ; Retrospective Studies ; Spinal Cord Compression - surgery ; Spinal Cord Diseases - diagnosis ; Spinal Cord Diseases - surgery ; Surgery ; Treatment Outcome</subject><ispartof>The spine journal, 2024-01, Vol.24 (1), p.87-93</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c311t-f0244b739a6058d5438dee0b764dca7be23c34e3bdee0722e27aed68479fa9d33</cites><orcidid>0000-0003-2100-5452</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37704047$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Dongwoo</creatorcontrib><creatorcontrib>Chang, Min Cheol</creatorcontrib><creatorcontrib>Jeon, Ikchan</creatorcontrib><creatorcontrib>Kim, Sang Woo</creatorcontrib><title>Diagnostic and prognostic significance of preoperative evoked potential tests in degenerative cervical myelopathy</title><title>The spine journal</title><addtitle>Spine J</addtitle><description>•Surgical decisions for degenerative cervical myelopathy (DCM) primarily depend on clinical symptoms and radiological examinations. Preoperative evoked potential testing is a functional diagnostic tool that can indicate the severity of myelopathic symptoms in patients with DCM. Additionally, preoperative tibial nerve-somatosensory evoked potential has significant prognostic value in predicting postoperative clinical outcomes. Thus, preoperative evoked potential tests are significantly helpful in determining suitable surgical treatment and forecasting postoperative prognosis.
Decompression surgery is a treatment option for patients with degenerative cervical myelopathy (DCM). Surgical decisions primarily depend on clinical symptoms and radiological examinations. The diagnostic and prognostic significance of evoked potential tests for surgical outcomes in patients with DCM has not been thoroughly examined.
To identify the diagnostic and prognostic significance of preoperative evoked potential tests in patients with DCM who underwent decompression surgery.
This was a retrospective observational study.
One hundred two consecutive patients who underwent evoked potential tests and surgical treatment between January 2016 and December 2020 in a single spine center and had a minimum follow-up of 6 months.
Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
This study evaluated the preoperative central motor conduction time (CMCT), somatosensory evoked potentials, and Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
Abnormal CMCT findings were observed in 94 patients (92.2%). Abnormal somatosensory evoked potentials were observed in 77 patients (75.5%). There was a statistically significant correlation between preoperative JOA score and abductor pollicis brevis (APB)-CMCT (r=−0.546, p=.001), tibialis anterior (TA)-CMCT (r=−0.517, p<.001), median nerve (MN)-SSEP (r=−0.353, p=.001), and tibial nerve (TN)-SSEP (r=−0.349, p=.003). There were significant differences in recovery rates associated with diabetes mellitus (DM), preoperative severity of myelopathy, TA-CMCT, MN-SSEP, and TN-SSEP. Stepwise multiple regression analysis showed that the major factors affecting the clinical outcomes were TN-SSEP (β=0.327, p=.004), preoperative JOA score (β=0.278, p=.012), and DM (β=0.241, p=.025).
Evoked potential testing is a functional diagnostic tool that can indicate the severity of myelopathic symptoms in patients with DCM. Additionally, preoperative TN-SSEP may have significant prognostic value in predicting postoperative clinical outcomes. Thus, preoperative evoked potential tests could be helpful for determining suitable surgical treatment candidates and forecasting postoperative prognosis.</description><subject>Cervical Vertebrae - surgery</subject><subject>Compressive myelopathy</subject><subject>Diagnosis</subject><subject>Evoked potentials</subject><subject>Evoked Potentials, Somatosensory</subject><subject>Humans</subject><subject>Prognosis</subject><subject>Prognostic factors</subject><subject>Retrospective Studies</subject><subject>Spinal Cord Compression - surgery</subject><subject>Spinal Cord Diseases - diagnosis</subject><subject>Spinal Cord Diseases - surgery</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>1529-9430</issn><issn>1878-1632</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtvEzEQgK0K1Bf8A4T2yGWX8SNr7wUJtYUiVeICZ8trzwaHjb21nUj593WUhiMnjz3fzHg-Qj5Q6CjQ_vOmy4sPiB0DxjsYOoD-glxTJVVLe87e1HjFhnYQHK7ITc4bAFCSsktyxaUEAUJek-d7b9Yh5uJtY4JrlhTP1-zXwU_emmCxiVNNYVwwmeL32OA-_sWKx4KheDM3BXPJjQ-NwzWGM2Yx7WuHudkecI6LKX8O78jbycwZ37-et-T3t4dfd4_t08_vP-6-PrWWU1raCZgQo-SD6WGl3Epw5RBhlL1w1sgRGbdcIB-Pr5IxZNKg65WQw2QGx_kt-XTqW1d63tXf6a3PFufZBIy7rJnqhRoUp6Ki4oTaFHNOOOkl-a1JB01BH2XrjT7J1kfZGgZdZdeyj68TduMW3b-is90KfDkBWPfce0w6W49Vp_MJbdEu-v9PeAHTBJWJ</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Yu, Dongwoo</creator><creator>Chang, Min Cheol</creator><creator>Jeon, Ikchan</creator><creator>Kim, Sang Woo</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2100-5452</orcidid></search><sort><creationdate>202401</creationdate><title>Diagnostic and prognostic significance of preoperative evoked potential tests in degenerative cervical myelopathy</title><author>Yu, Dongwoo ; Chang, Min Cheol ; Jeon, Ikchan ; Kim, Sang Woo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c311t-f0244b739a6058d5438dee0b764dca7be23c34e3bdee0722e27aed68479fa9d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cervical Vertebrae - surgery</topic><topic>Compressive myelopathy</topic><topic>Diagnosis</topic><topic>Evoked potentials</topic><topic>Evoked Potentials, Somatosensory</topic><topic>Humans</topic><topic>Prognosis</topic><topic>Prognostic factors</topic><topic>Retrospective Studies</topic><topic>Spinal Cord Compression - surgery</topic><topic>Spinal Cord Diseases - diagnosis</topic><topic>Spinal Cord Diseases - surgery</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yu, Dongwoo</creatorcontrib><creatorcontrib>Chang, Min Cheol</creatorcontrib><creatorcontrib>Jeon, Ikchan</creatorcontrib><creatorcontrib>Kim, Sang Woo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Dongwoo</au><au>Chang, Min Cheol</au><au>Jeon, Ikchan</au><au>Kim, Sang Woo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic and prognostic significance of preoperative evoked potential tests in degenerative cervical myelopathy</atitle><jtitle>The spine journal</jtitle><addtitle>Spine J</addtitle><date>2024-01</date><risdate>2024</risdate><volume>24</volume><issue>1</issue><spage>87</spage><epage>93</epage><pages>87-93</pages><issn>1529-9430</issn><eissn>1878-1632</eissn><abstract>•Surgical decisions for degenerative cervical myelopathy (DCM) primarily depend on clinical symptoms and radiological examinations. Preoperative evoked potential testing is a functional diagnostic tool that can indicate the severity of myelopathic symptoms in patients with DCM. Additionally, preoperative tibial nerve-somatosensory evoked potential has significant prognostic value in predicting postoperative clinical outcomes. Thus, preoperative evoked potential tests are significantly helpful in determining suitable surgical treatment and forecasting postoperative prognosis.
Decompression surgery is a treatment option for patients with degenerative cervical myelopathy (DCM). Surgical decisions primarily depend on clinical symptoms and radiological examinations. The diagnostic and prognostic significance of evoked potential tests for surgical outcomes in patients with DCM has not been thoroughly examined.
To identify the diagnostic and prognostic significance of preoperative evoked potential tests in patients with DCM who underwent decompression surgery.
This was a retrospective observational study.
One hundred two consecutive patients who underwent evoked potential tests and surgical treatment between January 2016 and December 2020 in a single spine center and had a minimum follow-up of 6 months.
Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
This study evaluated the preoperative central motor conduction time (CMCT), somatosensory evoked potentials, and Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
Abnormal CMCT findings were observed in 94 patients (92.2%). Abnormal somatosensory evoked potentials were observed in 77 patients (75.5%). There was a statistically significant correlation between preoperative JOA score and abductor pollicis brevis (APB)-CMCT (r=−0.546, p=.001), tibialis anterior (TA)-CMCT (r=−0.517, p<.001), median nerve (MN)-SSEP (r=−0.353, p=.001), and tibial nerve (TN)-SSEP (r=−0.349, p=.003). There were significant differences in recovery rates associated with diabetes mellitus (DM), preoperative severity of myelopathy, TA-CMCT, MN-SSEP, and TN-SSEP. Stepwise multiple regression analysis showed that the major factors affecting the clinical outcomes were TN-SSEP (β=0.327, p=.004), preoperative JOA score (β=0.278, p=.012), and DM (β=0.241, p=.025).
Evoked potential testing is a functional diagnostic tool that can indicate the severity of myelopathic symptoms in patients with DCM. Additionally, preoperative TN-SSEP may have significant prognostic value in predicting postoperative clinical outcomes. Thus, preoperative evoked potential tests could be helpful for determining suitable surgical treatment candidates and forecasting postoperative prognosis.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37704047</pmid><doi>10.1016/j.spinee.2023.09.006</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2100-5452</orcidid></addata></record> |
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| subjects | Cervical Vertebrae - surgery Compressive myelopathy Diagnosis Evoked potentials Evoked Potentials, Somatosensory Humans Prognosis Prognostic factors Retrospective Studies Spinal Cord Compression - surgery Spinal Cord Diseases - diagnosis Spinal Cord Diseases - surgery Surgery Treatment Outcome |
| title | Diagnostic and prognostic significance of preoperative evoked potential tests in degenerative cervical myelopathy |
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