Assessment of Intraoperative Neurophysiological Monitoring Techniques in Intramedullary Spinal Cord Tumor Removal Surgery

Nguyen MA, Ngo AP, Huynh QB and Pham TB

Department of Neurosurgery, University Medical Center, Ho Chi Minh City, Vietnam

^*Correspondance to: Anh Phung Ngo 

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Abstract:

Objective: Intraoperative neurophysiological monitoring in intramedullary spinal cord tumor removal surgery helps surgeons detect early warning signs of postoperative nerve damage, in order to reduce or prevent permanent neuron injury. We performed a study to evaluate the value of intraoperative neurophysiological monitoring techniques in intramedullary spinal cord tumor resection surgery.
Methods: We performed a retrospective study of 29 patients undergoing surgery for intramedullary spinal cord tumors and intraoperative neurophysiological monitoring during the period 2017-2021 at the University Medical Center, Ho Chi Minh City. Clinical assessment before and after surgery, intraoperative neurophysiological monitoring in surgery to find out the sensitivity, specificity, positive predictive value, and negative predictive value of intraoperative neurophysiological monitoring techniques.
Results: Of the 29 patients, 4 patients had worse postoperative neurological symptoms 13.8% at 1 day after surgery, then decreased to 10.3% at 1 month after surgery. SSEP (somatosensory evoked potential) has 75% sensitivity, and 72% specificity in detecting postoperative nerve damage, while the sensitivity and specificity of MEP (Motor Evoked Potential) are 100% and 80%, respectively.
Conclusion: Both SSEP and MEP have high sensitivity in detecting postoperative nerve damage, meanwhile, MEP is more sensitive than SSEP. These techniques help predict and possibly prevent timely neurological damage during intramedullary spinal cord resection surgery.

Keywords:

Intraoperative neurophysiological monitoring; Somatosensory evoked potential; Motor evoked potential; Intramedullary spinal cord tumor

Cite the Article:

Nguyen MA, Ngo AP, Huynh QB, Pham TB. Assessment of Intraoperative Neurophysiological Monitoring Techniques in Intramedullary Spinal Cord Tumor Removal Surgery. World J Surg Surgical Res. 2022; 5: 1424..