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The prediction of intraoperative cervical cord function changes by different motor evoked potentials phenotypes in cervical myelopathy patients

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机构: [1]Department of Orthopedics, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College, 1Shuai Fu Yuan, Beijing 100730, PR China [2]Department of Spine Surgery,Municipal Traditional Chinese Hospital, Weifang, Shandong 261041, PR China [3]China-America Institute of Neuroscience, Xuanwu Hospital, Capital MedicalUniversity, Beijing 100053, China
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关键词: Cervical compressive myelopathy (CCM) Motor evoked potential (MEP) Intraoperative neuromonitoring MEP baselines phenotypes Intraoperative cervical cord function changes

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Background Surgery is usually the treatment of choice for patients with cervical compressive myelopathy (CCM). Motor evoked potential (MEP) has proved to be helpful tool in evaluating intraoperative cervical spinal cord function change of those patients. This study aims to describe and evaluate different MEP baseline phenotypes for predicting MEP changes during CCM surgery. Methods A total of 105 consecutive CCM patients underwent posterior cervical spine decompression were prospectively collected between December 2012 and November 2016. All intraoperative MEP baselines recorded before spinal cord decompression were classified into 5 types (I to V) that were carefully designed according to the different MEP parameters. The postoperative neurologic status of each patient was assessed immediately after surgery. Results The mean intraoperative MEP changes range were 10.2% +/- 5.8, 14.7% +/- 9.2, 54.8% +/- 31.9, 74.1% +/- 24.3, and 110% +/- 40 in Type I, II, III, IV, and V, respectively. There was a significant correlation of the intraoperative MEP change rate with different MEP baseline phenotypes (r = 0.84, P < 0.01). Postoperative transient new spinal deficits were found 0/31 case in Type I, 0/21 in Type II, 1/14 in Type III, 2/24 in Type IV, and 4/15 in Type V. No permanent neurological injury was found in our cases series. Conclusions The MEP baselines categories for predicting intraoperative cervical cord function change is proposed through this work. The more serious the MEP baseline abnormality, the higher the probability of intraoperative MEP changes, which is beneficial to early warning for the cervical cord injury.

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出版当年[2019]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 临床神经病学
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出版当年[2018]版:
Q3 CLINICAL NEUROLOGY
最新[2023]版:
Q3 CLINICAL NEUROLOGY

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第一作者机构: [1]Department of Orthopedics, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College, 1Shuai Fu Yuan, Beijing 100730, PR China
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