ABSTRACT
OBJECTIVE: Our study’s objective was to assess how well intraoperative neurophysiological monitoring worked while removing intramedullary spinal cord tumors. These monitoring methods aim to stop or lessen irreversible nerve damage by identifying early indications of damage to the nerves. This is essential to make sure that the patient’s surgical removal of the tumor is effective. The objective of this study was to maintain the fine line between properly eliminating the tumor and maintaining nerve function.
METHODS: The accuracy of intraoperative neurophysiological monitoring methods used during intramedullary spinal cord tumor removal procedures was the focus of our investigation. 29 patients who received these surgeries at the Mayo Hospital in Lahore between February 2023 to February 2024 were subjected to a retrospective examination by our team. We evaluated the patient’s preoperative and postoperative clinical conditions as well as performed ongoing intraoperative neurophysiological monitoring to evaluate the effectiveness of various monitoring strategies. The findings of this study will provide us with important new information about how well these procedures preserve nerve function after intramedullary spinal cord tumour excision surgery.
RESULTS: We found an increasing trend in postoperative neurological symptoms in 4 patients in our retrospective research of 29 patients who had surgery for intramedullary spinal cord tumours. Initial incidence on the first day after surgery was 13.8%; however, after a month, it dropped to 10.3%. According to our data, intraoperative neurophysiological monitoring approaches are successful in spotting postoperative nerve damage. The motor evoked potential (MEP) had an even more astonishing 100% sensitivity and 80% specificity, while the somatosensory evoked potential (SSEP) exhibited a remarkable sensitivity of 75% and a specificity of 72%. These findings underline how crucial it is to use intraoperative neurophysiological monitoring methods during intramedullary spinal cord tumour removal procedures in order to detect and avoid postoperative nerve damage.
CONCLUSIONS: Our research demonstrated that both SSEP and MEP are very efficient in diagnosing postoperative nerve injury during intramedullary spinal cord excision surgery. These techniques are essential for foretelling and maybe preventing timely neurological injury during these procedures since MEP is significantly more sensitive than SSEP.
KEYWORDS: spinal cord, tumor, surgery, neurophysiological monitoring