Do intra-operative neurophysiological changes predict functional outcome following decompressive surgery for lumbar spinal stenosis? A prospective study.

Détails

ID Serval
serval:BIB_8A6A19E31F43
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Do intra-operative neurophysiological changes predict functional outcome following decompressive surgery for lumbar spinal stenosis? A prospective study.
Périodique
Journal of spine surgery
Auteur(s)
Piasecki K., Kulik G., Pierzchala K., Pralong E., Rao P.J., Schizas C.
ISSN
2414-469X (Print)
ISSN-L
2414-4630
Statut éditorial
Publié
Date de publication
03/2018
Peer-reviewed
Oui
Volume
4
Numéro
1
Pages
86-92
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To analyse the relation between immediate intraoperative neurophysiological changes during decompression and clinical outcome in a series of patients with lumbar spinal stenosis (LSS) undergoing surgery.
Twenty-four patients with neurogenic intermittent claudication (NIC) due to LSS undergoing decompressive surgery were prospectively studied. Intra operative trans-cranial motor evoked potentials (tcMEPs) were recorded before and immediately after surgical decompression. Lower limb normalised tcMEP improvement was used as primary neurophysiological outcome. Clinical outcome was assessed using the Zurich Claudication Questionnaire (ZCQ) self-assessment score, before surgery (baseline) and at an average of 8 and 29 months post-operatively.
We found a moderate positive correlation between tcMEP changes and ZCQ at early follow-up (R=0.36). At late follow-up no correlation was found between intra-operative tcMEP and ZCQ changes. Dichotomizing the data showed a statistically significant relationship between tcMEP improvement and better functional outcome at early follow-up (P=0.013) but not at later follow-up (P=1).
Our findings suggest that intra-operative neurophysiological improvement during decompressive surgery may predict a better clinical outcome at early follow-up although this is not applicable to late follow-up possibly due to the observed erosion of functional improvement with time.
Mots-clé
Lumbar spinal stenosis (LSS), clinical outcome, decompression surgery, intra-operative neurophysiological monitoring
Pubmed
Création de la notice
12/05/2018 9:22
Dernière modification de la notice
20/08/2019 14:49
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