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Article: Prognostic value of somatosensory-evoked potentials in the surgical management of cervical spondylotic myelopathy

TitlePrognostic value of somatosensory-evoked potentials in the surgical management of cervical spondylotic myelopathy
Authors
Issue Date2008
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2008, v. 33 n. 10, p. E305-E310 How to Cite?
AbstractSTUDY DESIGN. Preoperative somatosensory-evoked potentials (SEPs) were retrospectively analyzed and classified, and compared with surgical outcome. OBJECTIVE. To evaluate the value of the preoperative SEP waveform in predicting the clinical outcome after surgical management of cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA. SEPs have played an important role in spinal surgery. However, the value of SEPs in predicting the outcome of surgery for CSM remains controversial. METHODS. This study enrolled 76 CSM patients who underwent surgical intervention. Median nerve SEPs were recorded before surgery. The Japanese Orthopedic Association (JOA) scoring system was used to evaluate the neurologic function before surgery and at postoperative follow-up at 1, 3, 6, 12, and 24 months. Patients were divided into 5 groups according to the classification of their preoperative SEP waveforms. Group I patients had normal SEPs, group IIa had normal latency and abnormal amplitude, group IIb had abnormal latency and normal amplitude, group III had abnormal latency and amplitude, and group IV had immeasurable waveforms. The myelopathic disability scores and surgical outcomes in different groups were compared by the Kruskal-Wallis test. RESULTS. The SEP classification was found to be significantly associated with the JOA score (Pearson's χ test, χ = 53.9, P < 0.05). There were no significant differences in JOA score recovery at different follow-up times within any SEP group. At 24 months after surgery, there was no significant difference in the recovery ratio between groups I and IIa, or between groups IIb and III (Kruskal-Wallis test, P > 0.05). However, the recovery ratio was significantly higher in groups I and IIa than in all the other groups (Kruskal-Wallis test, P < 0.05), and in groups IIb and III than in group IV (Kruskal-Wallis test, P < 0.05). CONCLUSION. SEP classification correlates well with CSM disability and postoperative recovery ratio. Median nerve SEP recordings would be a valuable and practical tool for the diagnosis and prognosis of myelopathy. © 2008 Lippincott Williams & Wilkins, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/79444
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHu, Yen_HK
dc.contributor.authorDing, Yen_HK
dc.contributor.authorRuan, Den_HK
dc.contributor.authorWong, YWen_HK
dc.contributor.authorCheung, KMCen_HK
dc.contributor.authorLuk, KDKen_HK
dc.date.accessioned2010-09-06T07:54:45Z-
dc.date.available2010-09-06T07:54:45Z-
dc.date.issued2008en_HK
dc.identifier.citationSpine, 2008, v. 33 n. 10, p. E305-E310en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/79444-
dc.description.abstractSTUDY DESIGN. Preoperative somatosensory-evoked potentials (SEPs) were retrospectively analyzed and classified, and compared with surgical outcome. OBJECTIVE. To evaluate the value of the preoperative SEP waveform in predicting the clinical outcome after surgical management of cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA. SEPs have played an important role in spinal surgery. However, the value of SEPs in predicting the outcome of surgery for CSM remains controversial. METHODS. This study enrolled 76 CSM patients who underwent surgical intervention. Median nerve SEPs were recorded before surgery. The Japanese Orthopedic Association (JOA) scoring system was used to evaluate the neurologic function before surgery and at postoperative follow-up at 1, 3, 6, 12, and 24 months. Patients were divided into 5 groups according to the classification of their preoperative SEP waveforms. Group I patients had normal SEPs, group IIa had normal latency and abnormal amplitude, group IIb had abnormal latency and normal amplitude, group III had abnormal latency and amplitude, and group IV had immeasurable waveforms. The myelopathic disability scores and surgical outcomes in different groups were compared by the Kruskal-Wallis test. RESULTS. The SEP classification was found to be significantly associated with the JOA score (Pearson's χ test, χ = 53.9, P < 0.05). There were no significant differences in JOA score recovery at different follow-up times within any SEP group. At 24 months after surgery, there was no significant difference in the recovery ratio between groups I and IIa, or between groups IIb and III (Kruskal-Wallis test, P > 0.05). However, the recovery ratio was significantly higher in groups I and IIa than in all the other groups (Kruskal-Wallis test, P < 0.05), and in groups IIb and III than in group IV (Kruskal-Wallis test, P < 0.05). CONCLUSION. SEP classification correlates well with CSM disability and postoperative recovery ratio. Median nerve SEP recordings would be a valuable and practical tool for the diagnosis and prognosis of myelopathy. © 2008 Lippincott Williams & Wilkins, Inc.en_HK
dc.languageengen_HK
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.subject.meshAgeden_HK
dc.subject.meshCervical Vertebrae - surgeryen_HK
dc.subject.meshDecompression, Surgicalen_HK
dc.subject.meshDisability Evaluationen_HK
dc.subject.meshElectric Stimulationen_HK
dc.subject.meshEvoked Potentials, Somatosensoryen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMedian Nerve - physiopathologyen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPredictive Value of Testsen_HK
dc.subject.meshPreoperative Careen_HK
dc.subject.meshPrognosisen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshReaction Timeen_HK
dc.subject.meshRecovery of Functionen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshSeverity of Illness Indexen_HK
dc.subject.meshSpinal Cord Diseases - diagnosis - etiology - physiopathology - surgeryen_HK
dc.subject.meshSpinal Osteophytosis - complications - physiopathology - surgeryen_HK
dc.subject.meshTime Factorsen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titlePrognostic value of somatosensory-evoked potentials in the surgical management of cervical spondylotic myelopathyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0887-9869&volume=33&spage=E305&epage=10&date=2008&atitle=Prognostic+value+of+somatosensory-evoked+potentials+in+the+surgical+management+of+cervical+spondylotic+myelopathyen_HK
dc.identifier.emailHu, Y:yhud@hku.hken_HK
dc.identifier.emailCheung, KMC:cheungmc@hku.hken_HK
dc.identifier.emailLuk, KDK:hcm21000@hku.hken_HK
dc.identifier.authorityHu, Y=rp00432en_HK
dc.identifier.authorityCheung, KMC=rp00387en_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BRS.0b013e31816f6c8een_HK
dc.identifier.pmid18449030-
dc.identifier.scopuseid_2-s2.0-43049102039en_HK
dc.identifier.hkuros141689en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-43049102039&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume33en_HK
dc.identifier.issue10en_HK
dc.identifier.spageE305en_HK
dc.identifier.epageE310en_HK
dc.identifier.isiWOS:000255523300024-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridHu, Y=7407116091en_HK
dc.identifier.scopusauthoridDing, Y=37044095200en_HK
dc.identifier.scopusauthoridRuan, D=7004456354en_HK
dc.identifier.scopusauthoridWong, YW=36247941700en_HK
dc.identifier.scopusauthoridCheung, KMC=7402406754en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK

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