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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Postoperative outcome of patients with mild cervical spondylotic myelopathy: a comparison of patients with normal and abnormal preoperative SSEPs and MEPs and its predictive value

Meeting Abstract

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  • Vicki Butenschön - Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Anna Rienmüller - Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Jan S. Kirschke - Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Ehab Shiban - Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Jens Gempt - Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Bernhard Meyer - Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Yu-Mi Ryang - Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik und Poliklinik, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV126

doi: 10.3205/18dgnc128, urn:nbn:de:0183-18dgnc1284

Veröffentlicht: 18. Juni 2018

© 2018 Butenschön et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Patients with mild cervical spondylotic myelopathy (CSM; mJOA 15-17) are still a matter of debate regarding the indication for surgical decompression. The diagnostic methods in mild CSM encompasses clinical, radiographic and neurophysiological (somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs)) analysis. In our study, the aim was to evaluate the prognostic value of the different diagnostic methods on the postoperative clinical outcome.

Methods: A retrospective database analysis was performed and all patients with mild CSM operated between 2007 and 2016 were included and screened for preoperative SSEP and MEP evaluation. Out of 178 patients, 65 had preoperative normal and 113 presented with abnormal SSEPs and MEPs for analysis (mean age 61±13 yrs (range: 29-86)). All patients were treated via surgical decompression through anterior cervical discectomy and fusion (ACDF). Preoperative clinical and radiographic data, mJOA scores and the postoperative improvement on follow-up were analyzed and compared.

Results: The mean preoperative mJOA score was 16.7 and showed no significant difference between patients with and without normal electrophysiology. Most of them presented with gait disturbance (53% for normal MEPs and SSEPs and 78% with abnormal electrophysiology). More than half of all the patients (57%) showed a significant clinical improvement after surgical decompression, and almost 25% remained clinically stable on long-term follow-up.

Conclusion: In accordance with the present literature, CSM patients showed a significant improvement of clinical functionality after surgical decompression via ACDF. MEP/SSEP abnormal and normal patients had a significant benefit from the surgical treatment, suggesting that also patients without electrophysiological signs of spinal cord compression did significantly profit from the surgical treatment. Preoperative MEP/SSEP examination had no predictive influence on the clinical postoperative outcome.