Application of Neurophysiological Monitoring and Ultrasound Guidance in Intramedullary Decompression for Acute Spinal Cord Injury.

Abstract

Objective: To explore the clinical application value of neurophysiological monitoring combined with ultrasound guidance in Acute spinal cord injury.

Methods: Ten patients with acute spinal cord injury underwent intramedullary decompression surgery under neurophysiological monitoring and intraoperative ultrasound guidance. ASIA (American Spinal Injury Association) classification and JOA (Japan Orthopaedic Association) scoring were performed preoperatively and postoperatively.

Results: The preoperative, 1-week postoperative, and 1-year postoperative JOA scores for the ten patients were (6.2 ± 1.55), (7 ± 1.58), and (11.8 ± 1.60), respectively. The JOA improvement rates at 1 week and 1 year postoperation were 7.4% and 51.9%, respectively. Among the patients, one patient had severe thoracic spinal cord injury upon admission, and their ASIA classification remained at Grade A after 1 year postoperation, while the remaining nine patients showed varying degrees of neurological function improvement.

Conclusion: Intraoperative neurophysiological monitoring combined with intraoperative ultrasound not only allows for timely monitoring of spinal cord function but also enables observation of whether decompression is adequate during surgery. It represents a very good surgical option for patients with spinal cord injuries.