Cabañes-Martínez Lidia, Fedirchyk-Tymchuk Olga, López Viñas Laura, Abreu-Calderón Federico, Carrasco Moro Rodrigo, Del Álamo Marta, Regidor Ignacio
Clinical Neurophysiology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
Clinical Neurophysiology Department, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain.
J Clin Med. 2024 Dec 13;13(24):7588. doi: 10.3390/jcm13247588.
Due to the absence of studies supporting the role of intraoperative neurophysiological monitoring (IONM) in intradural spinal tumors, this study evaluates the clinical outcome after these surgeries in relation to the use of the advanced intraoperative neurophysiological techniques. This is an observational, descriptive and retrospective study of two cohort groups in relation to the presence or absence of IONM during the intervention and the subsequent evaluation of the clinical and functional results in the short and medium terms. Ninety-six patients with extra- or intramedullary intradural spinal tumors operated on by the neurosurgery team of our center completed the current study. We observed improvements in the Prolo, Brice and McKissock and McCormick scales scores in the monitored patients. These results examine the usefulness of IONM to preserve neurological functions and, therefore, its impact on quality of life. The rate of neurological deficits in the unmonitored patients was 14.5%, whereas it was 8.3% of the patients whose treatment included IONM. It is important to emphasize the importance of implementing IONM for early recognition of possible neurological damage, the improvement of postoperative functional outcomes, and for decreasing the rate of neurological complications. This study provides reliable results on the importance of IONM in intradural spinal tumor surgeries.
由于缺乏支持术中神经生理监测(IONM)在硬脊膜内脊髓肿瘤中作用的研究,本研究评估了这些手术在使用先进术中神经生理技术后的临床结果。这是一项针对两个队列组的观察性、描述性和回顾性研究,涉及干预期间IONM的有无以及随后对短期和中期临床及功能结果的评估。我们中心神经外科团队为96例患有硬脊膜外或髓内硬脊膜内脊髓肿瘤的患者进行了手术,这些患者完成了本研究。我们观察到接受监测的患者在普罗洛、布赖斯和麦基索克以及麦考密克量表评分方面有所改善。这些结果检验了IONM对保留神经功能的有用性,因此也检验了其对生活质量的影响。未接受监测的患者神经功能缺损发生率为14.5%,而接受IONM治疗的患者这一比例为8.3%。必须强调实施IONM对于早期识别可能的神经损伤、改善术后功能结果以及降低神经并发症发生率的重要性。本研究为IONM在硬脊膜内脊髓肿瘤手术中的重要性提供了可靠结果。