To identify the diagnostic and prognostic significance of preoperative evoked potential tests in patients with DCM who underwent decompression surgery.
This was a retrospective observational study.
One hundred two consecutive patients who underwent evoked potential tests and surgical treatment between January 2016 and December 2020 in a single spine center and had a minimum follow-up of 6 months.
Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
This study evaluated the preoperative central motor conduction time (CMCT), somatosensory evoked potentials, and Japanese Orthopedic Association (JOA) scores obtained preoperatively and 6 months after surgery.
Abnormal CMCT findings were observed in 94 patients (92.2%). Abnormal somatosensory evoked potentials were observed in 77 patients (75.5%). There was a statistically significant correlation between preoperative JOA score and abductor pollicis brevis (APB)-CMCT (r=-0.546, p=.001), tibialis anterior (TA)-CMCT (r=-0.517, p<.001), median nerve (MN)-SSEP (r=-0.353, p=.001), and tibial nerve (TN)-SSEP (r=-0.349, p=.003). There were significant differences in recovery rates associated with diabetes mellitus (DM), preoperative severity of myelopathy, TA-CMCT, MN-SSEP, and TN-SSEP. Stepwise multiple regression analysis showed that the major factors affecting the clinical outcomes were TN-SSEP (β=0.327, p=.004), preoperative JOA score (β=0.278, p=.012), and DM (β=0.241, p=.025).
Evoked potential testing is a functional diagnostic tool that can indicate the severity of myelopathic symptoms in patients with DCM. Additionally, preoperative TN-SSEP may have significant prognostic value in predicting postoperative clinical outcomes. Thus, preoperative evoked potential tests could be helpful for determining suitable surgical treatment candidates and forecasting postoperative prognosis.
目的:探讨术前诱发电位试验对DCM患者减压手术的诊断和预后意义。
方法:这是一项回顾性观察性研究。
方法:2016年1月至2020年12月期间,在单个脊柱中心接受诱发电位测试和手术治疗的102名连续患者,至少随访6个月。
方法:日本骨科协会(JOA)在手术前和手术后6个月获得的评分。
方法:本研究评估了术前中央运动传导时间(CMCT),体感诱发电位(SSEP),术前和术后6个月获得日本骨科协会(JOA)评分。
结果:在94例患者中观察到异常的CMCT表现(92.2%)。77例(75.5%)患者出现SSEP异常。术前JOA评分与短腿外展肌(APB)-CMCT之间有统计学意义的相关性(r=-0.546,p=0.000),胫骨前肌(TA)-CMCT(r=-0.517,p<=0.000),正中神经(MN)-SSEP(r=-0.353,p=0.001),和胫神经(TN)-SSEP(r=-0.349,p=0.003)。与糖尿病(DM)相关的康复率存在显着差异,术前脊髓病的严重程度,TA-CMCT,MN-SSEP,和TN-SSEP。逐步回归分析显示,影响临床结局的主要因素为TN-SSEP(β=0.327,p=0.004),术前JOA评分(β=0.278,p=0.012),和DM(β=0.241,p=0.025)。
结论:诱发电位测试是一种功能性诊断工具,可以指示DCM患者的脊髓病变症状的严重程度。此外,术前TN-SSEP在预测术后临床结局方面可能具有重要的预后价值。因此,术前诱发电位测试有助于确定合适的手术治疗方案和预测术后预后.