Analysis of the predictive efficacy and influencing factors of combined intraoperative neurophysiological monito-ring for nerve function injury during anterior cervical discectomy and fusion in patients with cervical spondylotic myelopathy
PENG Bo
PENG Zhi-heng
ZENG Qiao-yan
HUANG Wei-yuan
CHENG Long
LI Guang-sheng
SUN Xin
Abstract：Objective To investigate the efficacy of combined intraoperative neurophysiological monitoring(IONM)in predicting nerve function injury during anterior cervical discectomy and fusion(ACDF)surgery in patients with cervical spondylotic myelopathy(CSM)and analyze related influencing factors.Methods Clinical data from 45 CSM patients treated with ACDF surgery were collected.The relationship between the combined IONM(SEP+MEP)mo-nitoring results and postoperative nerve function changes was analyzed.Multivariate logistic regression analysis was used to explore the effects of age,disease duration,preoperative nerve function(mJOA score),high signal on MRI T2 images,number of compression segments,maximum canal compression(MCC),spinal cord compression ratio(SCCR),and spi-nal cord cross-sectional area(SCCA)on predictive efficacy.Results Intraoperative alarms were noted in 5 cases,and no alarms in 40 cases.Postoperative mJOA scores improved in 42 cases and worsened in 3 cases,showing significant im-provement in nerve function after surgery(P＜0.05).True positive cases:2;false positive cases:3;true negative ca-ses:39;false negative cases:1.Sensitivity:66.67％;specificity:92.85％;positive predictive value:40％;negative predictive value:97.50％.The association between intraoperative monitoring results and postoperative nerve function changes was statistically significant(P＜0.05).Multivariate logistic regression analysis showed no statistically significant differences in age,disease duration,preoperative mJOA score,high signal on MRI T2 images,number of compression segments,MCC,SCCR,and SCCA(P＞0.05).Conclusion Combined IONM can predict nerve function injury during ACDF surgery in CSM patients.Although preoperative factors do not significantly affect predictive efficacy,attention should be paid to differentiating surgical operations,blood pressure fluctuations,and hypothermia during surgery.
Keywords：intraoperative neuroelectrophysiological monitoringsomatosensory evoked potentialmotor evoked potentialanterior cervical discectomy and fusioncervical spondylotic myelopathy
Publication Date：2024-09-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1160-1165 )