Intraoperative changes in electrophysiological monitoring can be used to predict clinical outcomes in patients with spinal cavernous malformation.

IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Open Medicine Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI:10.1515/med-2024-1008
Xiaoyu Li, Hongqi Zhang, Jian Ren
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Abstract

Aim: The study aimed to evaluate the sensitivity and specificity of these monitoring parameters in predicting postoperative neurological dysfunction.

Methods: In this study, a total of 85 patients with spinal cavernous malformations (SCMs) treated at Xuanwu Hospital, Capital Medical University, from November 2012 to August 2017 were included. During the surgical procedures, all patients underwent monitoring of motor evoked potentials (MEP) and somatosensory evoked potentials (SEP). The criteria for warning included a reduction of ≥80% in MEP amplitude and ≥50% in SEP amplitude.

Results: Among 85 patients, 40 (47.1%) had SCMs located in the thoracic segment, 35 (41.2%) in the cervical segment, 6 (7.1%) in the cervical thoracic segment, and 4 (4.7%) in the lumbar segment. MEP recordings were obtained from 81 patients, and the preoperative McCormick score was 1.53 ± 0.69. The sensitivity of multimodal monitoring combined with the criteria of 80% reduction in MEP amplitude and SEP was 83.9%, with a specificity of 69%, a positive predictive value of 69%, and a negative predictive value of 90.4%.

Conclusion: This study emphasizes the crucial role of electrophysiological monitoring, particularly MEP and SEP, during the surgical resection of SCMs. The findings demonstrate that this approach is effective in predicting and preventing postoperative neurological dysfunction, thereby improving patient outcomes.

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术中电生理监测的变化可用于预测脊髓空洞畸形患者的临床预后。
目的:本研究旨在评估这些监测参数在预测术后神经功能障碍方面的敏感性和特异性:本研究共纳入2012年11月至2017年8月在首都医科大学宣武医院接受治疗的85例脊髓空洞畸形(SCMs)患者。在手术过程中,所有患者均接受了运动诱发电位(MEP)和体感诱发电位(SEP)监测。预警标准包括 MEP 振幅降低≥80%,SEP 振幅降低≥50%:85 名患者中,40 人(47.1%)的 SCM 位于胸椎段,35 人(41.2%)位于颈椎段,6 人(7.1%)位于颈胸椎段,4 人(4.7%)位于腰椎段。81 名患者获得了 MEP 记录,术前麦考密克评分为 1.53 ± 0.69。结合 MEP 振幅和 SEP 下降 80% 的标准,多模态监测的灵敏度为 83.9%,特异性为 69%,阳性预测值为 69%,阴性预测值为 90.4%:本研究强调了电生理监测,尤其是 MEP 和 SEP,在手术切除 SCM 时的关键作用。研究结果表明,这种方法能有效预测和预防术后神经功能障碍,从而改善患者的预后。
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来源期刊
Open Medicine
Open Medicine Medicine-General Medicine
CiteScore
3.00
自引率
0.00%
发文量
153
审稿时长
20 weeks
期刊介绍: Open Medicine is an open access journal that provides users with free, instant, and continued access to all content worldwide. The primary goal of the journal has always been a focus on maintaining the high quality of its published content. Its mission is to facilitate the exchange of ideas between medical science researchers from different countries. Papers connected to all fields of medicine and public health are welcomed. Open Medicine accepts submissions of research articles, reviews, case reports, letters to editor and book reviews.
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