Therapeutic Impact of Traction Release After C5 Nerve Root Motor Evoked Potential (MEP) Alerts in Cervical Spine Surgery
| Autor: | Eric A. Tesdahl, Thomas J. Epplin-Zapf, Mitali Bose, William B. Wilent, James S. Harrop, Anthony K. Sestokas, Jeffrey A. Cohen, John M. Rhee |
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| Rok vydání: | 2020 |
| Předmět: |
Cervical spine surgery
Nerve root medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Traction medicine Humans Orthopedics and Sports Medicine Evoked potential Retrospective Studies 030222 orthopedics business.industry Odds ratio Traction (orthopedics) Evoked Potentials Motor Regimen Anesthesia Cohort Anesthetic Cervical Vertebrae Surgery Neurology (clinical) Spinal Nerve Roots business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Clinical Spine Surgery: A Spine Publication. 33:E442-E447 |
| ISSN: | 2380-0186 |
| DOI: | 10.1097/bsd.0000000000000969 |
| Popis: | STUDY DESIGN A retrospective review of 40,919 cervical spine surgeries monitored with motor evoked potentials (MEPs) from a multi-institutional intraoperative neuromonitoring database. OBJECTIVE The objective of this study was to determine the clinical impact of interventions prompted by C5 spinal nerve root MEP alerts. SUMMARY OF BACKGROUND DATA MEPs have been shown to diagnose acute C5 palsies, but additional data are needed regarding the clinical impact of interventions in response to C5 MEP alerts. MATERIALS AND METHODS Procedures with isolated C5 MEP alerts were categorized as fully resolved, partially resolved, or unresolved based on the status of signals at closure. Clinical outcomes were based on neurological assessment in the immediate postoperative period. The sensitivity, specificity, likelihood ratios, and odds ratios (ORs) of C5 MEP alerts for acute C5 palsies were calculated. RESULTS The odds of an acute C5 palsy greatly increased if there was a C5 MEP alert [OR=340.9; 95% confidence (CI): 173.0, 671.6; P |
| Databáze: | OpenAIRE |
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