Risk Factor Analysis of Change in Intraoperative Neurophysiologic Monitoring During Cervical Open Door Laminoplasty
| Autor: | Ho Yong Choi, Hyun Jib Kim, Young Seop Park, Yong Chul Kwon, Sanghyun Han, Seung-Jae Hyun, Sung Min Kim, Tae Ahn Jahng, Ki-Jeong Kim, Kyung Seok Park |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Intraoperative Neurophysiological Monitoring Decompression medicine.medical_treatment Laminoplasty 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Spinal canal 030212 general & internal medicine Risk factor skin and connective tissue diseases Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Electromyography Magnetic resonance imaging Odds ratio Middle Aged medicine.disease Evoked Potentials Motor Magnetic Resonance Imaging Reflex Sympathetic Dystrophy Stenosis medicine.anatomical_structure ROC Curve Somatosensory evoked potential Anesthesia Surgery Female sense organs Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 119 |
| ISSN: | 1878-8769 |
| Popis: | Objective The aim of this study is to determine the risk factors affecting intraoperative neurophysiologic monitoring (IONM) changes, when such changes take place, and clinical outcomes associated with IONM change during cervical open door laminoplasty (COL) for cervical compressive myelopathy. Methods Between 2010 and 2015, 79 patients who underwent COL with IONM recording were studied. Changes in motor evoked potentials or somatosensory evoked potentials over an alarm criterion were defined as IONM change. Patients with IONM change were assigned to the alarm group, and the others were classified as the control group. Baseline data and radiographic measurements were compared between the 2 groups. Radiologic parameters including maximal compression level (MCL), area and diameter of the spinal canal and ventral compressive lesion, stenosis grade, and occupying ratio of area (ORA) and length at the MCL were measured with magnetic resonance imaging. Results Thirteen patients were assigned to the alarm group and 66 patients were assigned to the control group. Multivariate analysis identified ORA at the MCL (odds ratio, 1.520; 95% confidence interval, 1.192–1.37; P = 0.001) as an independent risk factor for IONM change. Immediately after decompression, the IONM change occurred. One of 4 patients who did not fully recover from the IONM change had postoperative motor deficits. Conclusions IONM change during COL occurred immediately after decompression, and a risk factor of IONM change was ORA at the MCL. If the IONM change was not fully recovered, a new motor deficit occurred after COL. |
| Databáze: | OpenAIRE |
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