Intradural extramedullary tumor location in the axial view affects the alert timing of intraoperative neurophysiologic monitoring.
Intradural extramedullary spinal tumor
Intraoperative spinal cord monitoring
Spinal surgery
Journal
Journal of clinical monitoring and computing
ISSN: 1573-2614
Titre abrégé: J Clin Monit Comput
Pays: Netherlands
ID NLM: 9806357
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
received:
11
08
2022
accepted:
31
12
2022
revised:
28
11
2022
medline:
15
5
2023
pubmed:
13
1
2023
entrez:
12
1
2023
Statut:
ppublish
Résumé
Intraoperative neurophysiologic monitoring (IONM) reportedly helps prevent postoperative neurological complications following high-risk spinal cord surgeries. There are negative and positive reports about using IONM for intradural extramedullary (IDEM) tumors. We investigated factors affecting alerts of IONM in IDEM tumor surgery. We analyzed 39 patients with IDEM tumors who underwent surgery using IONM at our hospital between January 2014 and March 2021. Neurological symptoms were evaluated pre- and postoperatively using the manual muscle test (MMT). All patients were evaluated to ascertain the tumor level and location in the axial view, the operative time, intraoperative bleeding volume, and histological type. Additionally, the intraoperative procedure associated with significant IONM changes in transcranial electrical stimulation muscle-evoked potential was investigated. There were 11 false-positive and 16 true-negative cases. There was one true-positive case and one false-negative case; the monitoring accuracy achieved a sensitivity of 50%, a specificity of 59%, a positive predictive value of 8%, and a negative predictive value of 94%. In the 22 alert cases, if the tumor was located anterolateral in the axial view, alerts were triggered with a significant difference (p = 0.02) during tumor resection. Alerts were generated for fifteen patients during tumor resection; nine (60%) showed waveform improvement by intervention and were classified as rescue cases. Alert is probably triggered during tumor resection for anterolaterally located tumors. Alerts during tumor resection procedures were more likely to be rescued than other procedures in IDEM tumor surgery.
Identifiants
pubmed: 36635568
doi: 10.1007/s10877-022-00971-6
pii: 10.1007/s10877-022-00971-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
775-782Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature B.V.
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