Intraoperative neuromonitoring loss in abnormal magnetic resonance imaging signal intensity from patients with cervical compressive myelopathy

Lin, Xiangquan; Li, Chaoxiong; Lin, Qin; Zheng, Zhong

doi:10.1016/j.jns.2017.08.3261

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Another point of view may be that better patient stratification is needed to improve prediction of outcomes. Lin et al 24 evaluated 152 patients with cervical compressive myelopathy and found that abnormal preoperative spinal cord T2 hyperintensity with T1 hypointensity was more likely in patients with IONM changes. The integration of imaging findings into preoperative stratification and prediction of outcomes in conjunction with IONM may be an interesting avenue of exploration in future studies.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Intraoperative Neuromonitoring during the Treatment of Cervical Myelopathy

Gamblin

Awad

Karsy

et al. 2023

Indian Journal of Neurosurgery

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Objective The accuracy of intraoperative neuromonitoring (IONM) during surgery for cervical spondylotic myelopathy (CSM) to detect iatrogenic nervous system injuries while they are reversible remains unknown. We evaluated a cohort of patients who had IONM during surgery to assess accuracy. Methods Patients who underwent surgical treatment of CSM that included IONM from January 2018 through August 2018 were retrospectively identified. A standardized protocol was used for operative management. Clinical changes and postoperative neurological deficits were evaluated. Results Among 131 patients in whom IONM was used during their procedure, 42 patients (age 58.2 ± 16.3 years, 54.8% males) showed IONM changes and 89 patients had no change. The reasons for IONM changes varied, and some patients had changes detected via multiple modalities: electromyography (n = 25, 59.5%), somatosensory-evoked potentials (n = 14, 33.3%), motor evoked potentials (n = 13, 31.0%). Three patients, all having baseline deficits before surgery, had postoperative deficits. Among the 89 patients without an IONM change, 4 showed worsened postoperative deficits, which were also seen at last follow-up. The sensitivity of IONM for predicting postoperative neurological change was 42.86% and the specificity was 68.55%. However, most patients (124, 94.7%) in whom IONM was used showed no worsened neurological deficit. Conclusions IONM shows potential in ensuring stable postoperative neurological outcomes in most patients; however, its clinical use and supportive guidelines remain controversial. In our series, prediction of neurological deficits was poor in contrast to some previous studies. Further refinement of clinical and electrophysiological variables is needed to uniformly predict postoperative neurological outcomes.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Intraoperative Neuromonitoring during the Treatment of Cervical Myelopathy

Gamblin

Awad

Karsy

et al. 2023

Indian Journal of Neurosurgery

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“…In a Kuwait study, young patients, with shorter duration of disease, mean EDSS score of 3.9, and highly active disease, showed greater improvement with the use of alemtuzumab. 71 …”

Section: Selection Of Candidate Patients For Alemtuzumabmentioning

confidence: 99%

The use of alemtuzumab in patients with relapsing-remitting multiple sclerosis: the Gulf perspective

Alroughani

Wijmeersch

Khaboori

et al. 2020

Ther Adv Neurol Disord

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Over the past decade, the development of high-efficacy disease-modifying therapies (DMTs) has been responsible for more effective management of relapsing-remitting multiple sclerosis (RRMS). However, the gaps in optimal care for this complex disease remain. Alemtuzumab (Lemtrada®) is a highly efficacious DMT that shows better patient outcomes and therapeutic benefits, but its use is under-recognized in the Gulf region. Experts in the care of multiple sclerosis shared their opinions based on study data and daily clinical experience in identifying the appropriate patient profile suitable for alemtuzumab’s therapeutic benefits. Age, disease activity and severity, disability status, physician experience, and economic condition are some of the key indicators for alemtuzumab use.

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Monitoring scoliosis and other spinal deformity surgeries

Nuwer

MacDonald²,

Gertsch

2022

Handbook of Clinical Neurology

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Intraoperative neuromonitoring loss in abnormal magnetic resonance imaging signal intensity from patients with cervical compressive myelopathy

Cited by 3 publications

References 19 publications

Efficacy of Intraoperative Neuromonitoring during the Treatment of Cervical Myelopathy

Efficacy of Intraoperative Neuromonitoring during the Treatment of Cervical Myelopathy

The use of alemtuzumab in patients with relapsing-remitting multiple sclerosis: the Gulf perspective

Monitoring scoliosis and other spinal deformity surgeries

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