Intraoperative Deterioration of Neurophysiological Potentials of the Spinal Tracts in Cervical Spine Surgery: Correlation with Patient-Related and Procedure-Related Variables

Avner Michaeli, Shmuel Appel, Joseph Danto, Akiva Korn, Josh E. Schroeder

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose:To identify characteristics associated with higher incidence of intraoperative deterioration of neurophysiological potentials related to spinal tracts in cervical spine surgeries.Methods:Electrophysiological raw data and neurophysiological case reports of 1,611 patients from multiple medical centers, who underwent cervical spine surgery for decompression and/or fusion, were retrospectively reviewed. Patient-related and procedure-related variables were identified and analyzed for correlation with intraoperative neurophysiological event of the spinal tracts. The neurophysiological events were analyzed for identification of collective characteristics.Results:The study cohort presented consistent dominancy of male over female patients (67% vs. 33%). Intraoperative deterioration of spinal tract-derived potentials was noted in 10.5% of the total cases, which was not correlated with gender, age, or indication of the surgery. Higher incidence of neurophysiological events was noted in patients with impaired baseline of motor evoked potentials from the thenar muscle (P = 0.01) or somatosensory evoked potentials of the posterior tibial nerve (P = 0.0002). Procedures of circumferential approach or procedures that involved ≥3 spinal levels demonstrated higher incidence of neurophysiological events as well (P = 0.0003 and 0.001, respectively).Conclusions:Patients with deteriorated neurophysiological baseline and procedures of extensive intervention are at higher risk of intraoperative neurophysiological event in cervical spine surgery. Inclusion of intraoperative neurophysiological monitoring should be encouraged in complicated cases of cervical spine surgeries.

Original languageEnglish
Pages (from-to)325-330
Number of pages6
JournalJournal of Clinical Neurophysiology
Volume40
Issue number4
DOIs
StatePublished - 1 May 2023

Keywords

  • Cervical spine surgery
  • Intraoperative neurophysiological event
  • Motor evoked potential
  • Somatosensory evoked potential
  • Spinal long tracts

ASJC Scopus subject areas

  • Physiology
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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