Grasso Giovanni, Petralia Tito, Torregrossa Fabio, Basile Luigi, Cusumano Luigi, Rodolico Alessandro, Iacopino Domenico
University of Palermo, Palermo, Italy.
University of Catania, Catania, Italy.
Eur Spine J. 2025 Jun 18. doi: 10.1007/s00586-025-09064-9.
The aim of this study was to evaluate the relationships between changes in intraoperative neurophysiological monitoring (IONM) and patient-related outcomes (PROs), by Brief Pain Inventory (BPI) questionnaire and the MD Anderson Symptom Inventory (MDASI) questionnaire, in a cohort of patients operated on for thoracic spinal meningioma (SM).
This is a retrospective study on patients operated on for thoracic SMs in whom IONM was used. BPI and the MDASI were recorded preoperatively, at 1-month, 6- and 12-month follow-up. The Wilcoxon signed-rank test was used to evaluate significant differences between preoperative and postoperative individual items from the MDASI, BPI, and neurological dysfunction through the modified McCormick scale (mMCS). To compare differences in outcome measures, repeated measures ANOVA were performed. Spearman's rank-order correlation was used to analyze the degree of association between the variables after surgery. Statistical significance was set at p < 0.05.
A total of 183 patients operated on for thoracic SM were included. Of these, 95 (52%) had no change in IONMs during surgery, 30 (16%) had a worsening in motor, sensory, or mixed recordings, and 58 (32%) had an improvement in intraoperative recordings. Both the MDASI and BPI showed a statistically significant improvement from the baseline to the first follow-up (p > 0.001), remaining stable over time.
In our series, we observed statistical significance differences between favorable IONM, neurological outcome, and PROs. Further studies with a larger sample size and a longer follow-up may provide more conclusive results.
本研究旨在通过简短疼痛问卷（BPI）和MD安德森症状问卷（MDASI），评估一组接受胸椎脊膜瘤（SM）手术患者的术中神经生理监测（IONM）变化与患者相关结局（PRO）之间的关系。
这是一项对接受胸椎SM手术且使用IONM的患者的回顾性研究。术前、术后1个月、6个月和12个月随访时记录BPI和MDASI。采用Wilcoxon符号秩检验评估MDASI、BPI术前和术后各项目以及通过改良麦考密克量表（mMCS）评估的神经功能障碍之间的显著差异。为比较结局指标的差异，进行重复测量方差分析。采用Spearman等级相关分析术后变量之间的关联程度。设定统计学显著性水平为p < 0.05。
共纳入183例接受胸椎SM手术的患者。其中，95例（52%）手术期间IONM无变化，30例（16%）运动、感觉或混合记录恶化，58例（32%）术中记录改善。MDASI和BPI从基线到首次随访均显示出统计学显著改善（p > 0.001），且随时间保持稳定。
在我们的系列研究中，我们观察到良好的IONM、神经学结局和PRO之间存在统计学显著差异。样本量更大、随访时间更长的进一步研究可能会提供更确凿的结果。
