Journal of neurosurgical sciences最新文献

{"title":"Long-segment versus short-segment fixation through a posterior approach for tuberculous spondylodiscitis of the mid-thoracic spine in adults: a study of mid- to long-term efficacy.","authors":"Zhenchao Xu, Xiyang Wang, Zhen Zhang","doi":"10.23736/S0390-5616.21.05225-5","DOIUrl":"10.23736/S0390-5616.21.05225-5","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study aimed to perform a comparative evaluation of the mid- to long-term efficacy of long-segment and short-segment fixations via the posterior approach as a treatment for tuberculous spondylodiscitis in the mid-thoracic spine.</p><p><strong>Methods: </strong>A total of 95 patients with tuberculous spondylodiscitis in the mid-thoracic spine underwent surgery via the posterior approach including single-stage posterior debridement, interbody fusion, and pedicle screw fixation. Long-segment fixations were performed for 46 patients (group A), while short-segment fixations were performed for the other 49 patients (group B). Clinical and radiological outcomes were assessed during mid- to long-term follow-up.</p><p><strong>Results: </strong>The average follow-up periods for groups A and B were 75.5±11.8 and 76.8±11.6 months, respectively. The operative time and intraoperative blood loss were lower in group B than in group A (P<0.05). Both management approaches significantly corrected the kyphotic deformity detected either in the early postoperative period or at the final visit after long-term follow-up (P>0.05). Bony fusion was generated after average periods of 10.8±2.1 months and 11.0±2.0 months in groups A and B, respectively. Favorable outcomes were observed on assessment of neurological function and patients' well-being at the final follow-up.</p><p><strong>Conclusions: </strong>No therapeutic differences were observed between long-segment and short-segment fixation as surgical treatment for mid-thoracic Pott's disease during mid- to long-term follow-up. Kyphotic deformity and neurological impairment were significantly relieved via both posterior fixation approaches, with patients' well-being reaching a favorable level. Moreover, short-segment fixation led to less blood loss and required a shorter operative time.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25468348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Th17/Treg imbalance in peripheral blood from patients with intracranial aneurysm.","authors":"Miaomiao Song, Zhibin Jin, Peng Wang, Xiang Zhang","doi":"10.23736/S0390-5616.21.05567-3","DOIUrl":"10.23736/S0390-5616.21.05567-3","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous subarachnoid hemorrhage (SAH) is highly associated with ruptured intracranial aneurysm (IA), which dramatically increases neurological disabilities or mortality in patients. The balance between T helper cells (Th17) and regulatory T cells (Treg) plays a crucial role in regulating immune-inflammatory response. In the current study, we aim to obtain a better understanding of the role of Th17 and Treg cells in patients with IA.</p><p><strong>Methods: </strong>138 patients total participated in this study, including ruptured aneurysms group (Ruptured IA, RIA, N.=70 cases) and unruptured aneurysms group (Unruptured IA, URIA, N.=68 cases). Additionally, 76 cases of healthy subjects were selected as control group. The frequencies of Th17 and Treg cells were determined using flow cytometry. The serum levels of cytokines including IL-17, IL-23, IL-10, and TGF-β1 were determined using ELISA. mRNA was isolated from the whole blood. FOXP3 and RCRc mRNA expressions were detected using RT-qPCR.</p><p><strong>Results: </strong>The percentage of Th17 cells in peripheral blood from RIA patients was higher than URIA patients (P<0.01), whereas the percentage of Treg cells in peripheral blood from RIA was significantly lower when compared with URIA patients (P<0.001). The serum levels of IL-17 (P<0.01) and IL-23 (P<0.05) were markedly increased while the levels of IL-10 (P<0.01) and TGF-β1 (P<0.05) were decreased in RIA patients when compared with URIA patients. Lastly, the mRNA level of RCRc was significantly increased in RIA vs. URIA patients (P<0.001). By contrast, FOXP3 mRNA level was significantly decreased in RIA vs. URIA patients (P<0.001).</p><p><strong>Conclusions: </strong>In the current study, we demonstrated the imbalance of Th17/Treg in patients with IA, and the frequencies of Th17 cells were positively correlated with the severity of IA-induced SAH. These results provided data to support that targeting Th17/Treg could act as an effective approach for the management of IA.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39519183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De novo cavernous angiomas associated with developmental venous anomaly: a mini-series and literature review.","authors":"Vincenzo Antonelli, Giuseppe Maimone, Dalila Fuschillo, Alessandra Turrini, Riccardo Draghi, Luca Riccioni, Fabio Calbucci, Luigino Tosatto","doi":"10.23736/S0390-5616.21.05512-0","DOIUrl":"10.23736/S0390-5616.21.05512-0","url":null,"abstract":"<p><strong>Background: </strong>Despite being previously considered as congenital lesions, recent studies agree to classify cerebral cavernous malformations (CCM) as acquired forms with clear correlations with other pathological affections of the central nervous system (CNS). In addition, a special subgroup, notably known as de novo CCMs (dnCCM), are associated in a significant number of cases with developmental venous anomalies (DVAs) and, in other cases, with Radiotherapy treatments.</p><p><strong>Methods: </strong>A mini-series of 4 patients with clinical history characterized by developing dnCCM is reported. In three patients, the dnCCM was associated with the presence of an isolated DVA. In one case, no DVA was detected, but the patient underwent brain radiotherapy. In three cases, the dnCCM was clinically symptomatic, and the patients were submitted to a surgical procedure for lesion removal. In one case, the dnCCM was detected during MRI follow-up.</p><p><strong>Results: </strong>Adding a review of the literature, we describe 47 patients who presented dnCCMs. The most common presentation is a sporadic CCM with a DVA, and the onset presentation was bleeding in 4 out of 47 cases (8.5%). Bleeding of dnCCM was observed in 9 out of 47 cases (19%), and the choice treatment was surgical in 24 out of 47 cases (51%).</p><p><strong>Conclusions: </strong>We present our series with a review of the recent literature and discuss the \"de novo\" cavernous malformation pathogenesis. A throughout review of recent literature is reported to clarify the predisposing factors that may lead to dnCCM development in patients carrying specific genetic and molecular features. Considering the high risk of bleeding, strict follow-up and aggressive treatment should be evaluated in dnCCM management.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47825794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bartolomeo Panizza (1785-1867) and his contribution to the discovery of the visual cortex.","authors":"Paolo Perrini, Davide T DI Carlo, Arianna Fava, Nicola Montemurro","doi":"10.23736/S0390-5616.22.05696-X","DOIUrl":"10.23736/S0390-5616.22.05696-X","url":null,"abstract":"<p><p>Bartolomeo Panizza (1785-1867) was an eminent anatomist and a pupil of Antonio Scarpa (1752-1832) at the University of Pavia. In 1855, before the revolutionary studies of Paul Broca (1824-1880) on aphasia that supported the theory of cortical localizations, Panizza delivered a lecture in Milan on the anatomy of the visual system, Osservazioni sul Nervo Ottico (\"Observations on the optic nerve\"). This lecture contains the first description of the cortical projection of the visual pathways in the occipital lobe, anticipating the revolutionary studies performed by Hermann Munk (1839-1912) in the late 19^th century. The findings of Panizza questioned the assumption of the French physiologist, Marie-Jean-Pierre Flourens (1794-1867) who was defending the holistic concept of cerebral equipotentiality, which was widely accepted among the scientific community in the early 19^th century. The present essay highlights the life and the scientific studies of Bartolomeo Panizza, with emphasis on the issue of cerebral localization that was simmering in the scientific community at that time.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9425642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar adjacent segment degeneration after spinal fusion surgery: a systematic review and meta-analysis.","authors":"Delia Cannizzaro, Carla D Anania, Adrian Safa, Ismail Zaed, Manuela Morenghi, Marco Riva, Massimo Tomei, Federico Pessina, Franco Servadei, Alessandro Ortolina, Maurizio Fornari","doi":"10.23736/S0390-5616.22.05891-X","DOIUrl":"10.23736/S0390-5616.22.05891-X","url":null,"abstract":"<p><strong>Introduction: </strong>Adjacent segment degeneration is among the most recognized long-term complications of lumbar surgery for degenerative spine pathologies with a relevant impact in spine surgical and clinical practice. It is reported a incidence of clinical adjacent segment disease between 5-30% of patients undergoing spinal fusion. We aimed to evaluate the main clinical and surgical risk factors for developing adjacent segment disease.</p><p><strong>Evidence acquisition: </strong>A systematic review and meta-analysis of the pertinent literature was performed, according to PRISMA and PICO guidelines, focusing on clinical and radiological adjacent segment disease. We exclusively included studies reporting demographic and clinical data, and surgical details published from 30 September 2015 to 30 September 2020. The effect of considered risk factors on the presence of adjacent segment disease was explored with a random-effects model.</p><p><strong>Evidence synthesis: </strong>A total of 15 scientific publications, corresponding to 6253 patients, met the inclusion criteria for the qualitative and quantitative analysis. 720 of the patients developed a clinical and/or radiological adjacent syndrome disease, and 473 have been surgically managed. Ten articles qualified for the comparative geographical analysis. Advanced age and obesity are relevant risk factors for developing lumbar adjacent segment degeneration. Our data also reported a higher prevalence of adjacent segment degeneration in Western populations than in Eastern populations. The interbody fusion has a protective role toward lumbar adjacent segment degeneration.</p><p><strong>Conclusions: </strong>This study highlighted multifactorial issues regarding adjacent segment disease: clinical, anatomical, biomechanical, and radiological features. In view of increasing life expectancy and spinal surgery procedures, extensive multicenter studies will be needed to define the correct management of the adjacent segment disease.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40671159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on interest in pediatric neurosurgery related symptoms, diseases, and treatments.","authors":"Mustafa Güdük, Ömer Orhun, Ahmet T Dursun, Doğu Küçüksüleymanoğlu, Zeynep Deniz, Murat I Usseli, Baran Bozkurt, Sinan Kardeş, Murat Ş Ekşi","doi":"10.23736/S0390-5616.21.05416-3","DOIUrl":"10.23736/S0390-5616.21.05416-3","url":null,"abstract":"<p><strong>Background: </strong>More and more often, patients use online resources to increase their knowledge/confidence in conventional medicine. Thus, the evaluation of the internet search trends may offer an insight into patients' perception of the healthcare system during the pandemic, especially for medical specialties with invasive interventions such as pediatric neurosurgery.</p><p><strong>Methods: </strong>A total of 140 keywords representing a wide range of pediatric neurosurgery related symptoms/signs, diseases, and treatments were defined. Google Trends tool was queried for the predefined keywords within the United States from January 01, 2016, to November 17, 2020. Two periods in 2020, March 15to July 4and July 5to October 31, were compared with similar periods over the preceding four years (2016-2019). We performed analyses in three sections: symptoms/signs, diseases, and treatments.</p><p><strong>Results: </strong>Public interest has shifted from regular pediatric neurosurgery related symptoms/signs, diseases, and treatments to the ones related with neurological aspects of COVID-19 both in initial and short-term stages of the pandemic.</p><p><strong>Conclusions: </strong>Google Trends highlights that the link between neurosurgeon/pediatric patients/caregivers needs to be further empowered by growing educational efforts.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39084148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of double-stent assisted coil embolization in intracranial vertebral artery dissecting aneurysms with mass effect.","authors":"Long-Jiang Zhou, Wei Wang, Li-Li Wen, Qi Wu, Zhen-Sheng Liu, Xiao-Yu Tang, Wei Cai, Xiao-Ming Zhou, Wei-Zhen He, Xin Zhang","doi":"10.23736/S0390-5616.22.05599-0","DOIUrl":"10.23736/S0390-5616.22.05599-0","url":null,"abstract":"<p><strong>Background: </strong>Unruptured intracranial vertebral artery dissecting aneurysms (IVADAs) with mass effect have an extremely poor natural course, and treatment of these aneurysms remains a challenge for endovascular and surgical strategies. The aim of this study was to analyze the role of double-stent-assisted coil embolization in preventing rupture and bleeding of intracranial vertebral artery dissecting aneurysm with brainstem compression by reducing mass effect and preventing the recurrence of the aneurysm.</p><p><strong>Methods: </strong>A total of 25 patients (mean age, 56.04±13.0 years) with unruptured IVADAs with mass effect received dual-stent-assisted coil embolization. The baseline characteristics, the change of aneurysm size on MR, the rate of retreatment, and the improvement rate of clinical symptoms and signs were analyzed retrospectively.</p><p><strong>Results: </strong>All patients completed the surgical procedures successfully. No aneurysm bleeding or perforating artery occlusion occurred during the perioperative and follow-up periods. The initial maximum diameter of the aneurysm on MR was 17.5±3.6 mm. One year after treatment, the maximum diameter of the aneurysm on MR was 15.8±4.9 mm. The reduction rate of the maximum diameter of the aneurysm was 10.7±12.7%. The change of the maximum diameter before and after treatment of aneurysm was statistically significant (P<0.001). In terms of the improvement rate of clinical symptoms, 15 cases were completely improved (60.0%), 6 cases were partially improved (24.0%), and the total clinical improvement rate was 84%. Four cases (16.0%) showed no improvement or even had aggravation of clinical symptoms. In 5 cases (20.0%), aneurysms recurred. Among 4 cases involving posterior inferior cerebellar artery origin, 3 cases had the recurrence (75%). 5 recurred cases were treated with single-stent-assisted coil embolization. No residual aneurysm and recurrence were found on the follow-up angiography.</p><p><strong>Conclusions: </strong>The double-stent-assisted coil embolization procedure is very safe and reliable. It can effectively prevent the aneurysm from continuing to grow and rupture and thereby reduce the clinical symptoms caused by the mass effect.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68828409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can clinicians correctly predict intracranial pressure state based on clinical symptoms alone in shunted patients?","authors":"Sogha Khawari, Anand Pandit, Laurence Watkins, Ahmed Toma, Lewis Thorne","doi":"10.23736/S0390-5616.23.06065-4","DOIUrl":"https://doi.org/10.23736/S0390-5616.23.06065-4","url":null,"abstract":"<p><strong>Background: </strong>Clinicians are well-versed in the classical symptoms of low vs. high intracranial pressure (ICP). However, symptoms may not be as predictable of ICP state in shunted patients with chronic symptoms. In this study, we assess whether clinicians can predict high vs. low ICP state in chronically symptomatic shunted patients without any diagnostic clues.</p><p><strong>Methods: </strong>A detailed retrospective analysis was performed on 259 patients undergoing ICP monitoring. A total of 17 patients who had a ventriculoperitoneal shunt were identified, with a suspected chronic abnormal ICP state based only on clinical symptoms. Patients with investigations guiding towards a likely pressure state were excluded, e.g., imaging or ophthalmological findings suggestive of ICP state.</p><p><strong>Results: </strong>Clinical suspicion of ICP state was incorrect in 16 out of 17 cases (P<0.05). The symptoms described by patients were suggestive of abnormal ICP states; however, 13 out of 17 cases demonstrated ICP within the normal range (-1.3 to 5.3 mmHg). Three patients with occipital headaches worse on standing, typical of low-pressure symptoms, were in fact shown to have ICP above 10.0 mmHg.</p><p><strong>Conclusions: </strong>This study casts doubt on the utility of classic symptoms in diagnosing abnormal ICP state in chronically symptomatic shunted patients with equivocal adjuncts. Additionally, it highlights the importance of ICP monitoring for this patient group.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of predicted postoperative segmental lumbar lordosis in spinal fusion using an intraoperative robotic planning and guidance system.","authors":"Ghani Haider, Vaibhavi Shah, Thomas Johnstone, Nicolai Maldaner, Martin Stienen, Anand Veeravagu","doi":"10.23736/S0390-5616.23.06142-8","DOIUrl":"https://doi.org/10.23736/S0390-5616.23.06142-8","url":null,"abstract":"<p><strong>Background: </strong>Restoring lumbar lordosis is one of the main goals in lumbar spinal fusion surgery. The Mazor X-Align^TM software allows for the prediction of postoperative segmental lumbar lordosis based on preoperative imaging. There is limited data on the accuracy of this preoperative prediction, especially in patients undergoing short segment lumbar fusion. The objective of our study was to determine the accuracy of predicted postoperative segmental lumbar lordosis using the Mazor X-Align^TM software in patients requiring short segmental fusion.</p><p><strong>Methods: </strong>Retrospective analysis of adult patients undergoing pedicle screw spinal instrumentation of not more than four levels using the Mazor X^TM Robot (Medtronic Inc., Minneapolis, MN, USA) between July 2017 to June 2020. The robotic guidance software, Mazor X-Align^TM (Medtronic Inc., Minneapolis, MN, USA) was used to calculate the predicted segmental lumbar lordosis based on preoperative CT-imaging and the plan was executed under intraoperative robotic guidance. Predicted segmental lumbar lordosis was compared to achieved segmental lumbar lordosis on 1-month postoperative x-rays using the Cobb angle methodology.</p><p><strong>Results: </strong>A total of 15 patients (46.6% female) with a mean age of 61.5±10.9 years were included. All patients underwent posterior lumbo-sacral spinal fusion with the Mazor X^TM robotic system with 11 patients (73.3%) undergoing anterior column reconstruction prior to posterior fixation. Instrumentation was performed across a mean of 2.6 levels per case. Preoperative, the mean segmental lumbar lordosis was 30.2±13.6 degrees. The mean planned segmental lumbar lordosis was 35.5±17.0 degrees while the mean achieved segmental lumbar lordosis was 35.8±16.7 degrees. There was no significant mean difference between the planned and achieved segmental lumbar lordosis (P=0.334).</p><p><strong>Conclusions: </strong>The Mazor X^TM intraoperative robotic planning and guidance is accurate in predicting postoperative segmental lumbar lordosis after short segmental fusion. Our findings may assure surgical decision making and planning.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limits and usefulness of intraoperative evoked potentials during laminoplasty.","authors":"Rossella Rispoli, Christian Lettieri, Giada Pauletto, Gabriele Valiante, Yan Tereshko, Barbara Cappelletto","doi":"10.23736/S0390-5616.23.06077-0","DOIUrl":"https://doi.org/10.23736/S0390-5616.23.06077-0","url":null,"abstract":"<p><strong>Background: </strong>Over the past 10 years, intraoperative neurophysiological monitoring (IONM) has been widely performed during surgery for treating spondylotic cervical myelopathy. Our study considers the predictive value of IONM during laminoplasty, regarding, first, the adequacy of spinal cord decompression and, second, the long-term neuro-functional outcome.</p><p><strong>Methods: </strong>We considered 38 patients with the diagnosis of degenerative cervical myelopathy who underwent an open-door laminoplasty. All patients were evaluated preoperatively, and at three and 12 months postoperatively, with the Japanese Orthopedic Association (JOA) point scale. Upper and lower limb somatosensory and motor evoked potentials (SSEPs and MEPs) were recorded preoperatively and intraoperatively.</p><p><strong>Results: </strong>During surgery, three of 38 patients showed a deterioration of SSEPs and MEPs compared to baseline values. Surgery was then converted from laminoplasty to laminectomy, resulting in the gradual restoration of the evoked potentials. The neurophysiological parameter significantly associated with a better clinical outcome was the latency of lower limbs MEPs. The 12 patients who had a more prominent reduction of the MEPs latency at the end of surgery showed a higher post-surgical JOA score, increasing ≥30% compared to baseline values at the 3- and 12-month follow-up.</p><p><strong>Conclusions: </strong>Though not a predictor of clinical outcome, the IONM was essential to evaluate the effectiveness of spinal cord decompression. Reduced latency of lower limbs MEPs may predict a better clinical outcome. We suggest that IONM in patients with degenerative cervical myelopathy should be routine. It is necessary to conduct larger studies to clarify the predictive value of IONM.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136397766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}