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Comparison of intraoperative neurophysiologic monitoring outcomes between cervical and thoracic spine surgery

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Abstract

Purpose

The objective is to compare the intraoperative monitoring (IOM) outcomes between degenerative cervical and thoracic spine decompression surgery.

Method

A total of 97 patients with cervical compression myelopathy (CCM) and 75 patients with thoracic compression myelopathy (TCM) were prospectively collected between December 2012 and June 2015 in our spine center. Somatosensory-evoked potentials (SSEP) and motor-evoked potentials (MEP) were used for IOM. The postoperative neurologic status of each patient was assessed immediately after surgery. And the IOM and neurological outcomes were mainly analyzed in this study.

Results

Under the same alarm criteria, the IOM changes present significant difference between the cervical and thoracic surgery. During the patients with monitoring alerts, the MEPs usually manifest as sudden loss in TCM whereas the gradual loss in CCM. And there were three permanent neurologic injuries in the thoracic cases, but none in cervical cases.

Conclusion

The IOM loss between CCM and TCM patients present obvious difference and the sudden MEPs loss associated with spinal decompression need to be taken seriously especially in TCM.

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Author information

Author notes

  1. Shujie Wang and Yuan Tian contributed equally to this paper.

Authors and Affiliations

  1. Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People’s Republic of China

    Shujie Wang, Yu Zhao, Jiliang Zhai & Ye Tian

  2. Department of Anesthesia, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People’s Republic of China

    Yuan Tian

  3. Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, People’s Republic of China

    Xiangquan Lin

  4. Department of Spine Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, 261000, People’s Republic of China

    Zhifu Ren

  5. Nursing Department, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People’s Republic of China

    Xiaojuan Zhang, Yanwei Zhao & Yingyue Dong

  6. Department of Orthopedics, Longnan Hospital of Daqing, Daqing, 163000, Hei Longjiang, People’s Republic of China

    Congran Zhao

Authors
  1. Shujie Wang
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  2. Yuan Tian
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  3. Xiangquan Lin
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  5. Yu Zhao
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  10. Congran Zhao
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  11. Ye Tian
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Corresponding author

Correspondence to Ye Tian.

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Wang, S., Tian, Y., Lin, X. et al. Comparison of intraoperative neurophysiologic monitoring outcomes between cervical and thoracic spine surgery. Eur Spine J 26, 2404–2409 (2017). https://doi.org/10.1007/s00586-017-5194-4

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  • DOI: https://doi.org/10.1007/s00586-017-5194-4

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