Functional Outcome in Spinal Meningioma Surgery and Use of Intraoperative Neurophysiological Monitoring
Data on intraoperative neurophysiological monitoring (IOM) during spinal meningioma (SM) surgery are scarce. The aim of this study was to assess the role of IOM and its impact on post-operative functional outcome. Eighty-six consecutive surgically treated SM patients were included. We assessed pre a...
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MDPI AG
2022-08-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/16/3989 |
| _version_ | 1797410953694806016 |
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| author | Christopher Marvin Jesse Pablo Alvarez Abut Jonathan Wermelinger Andreas Raabe Ralph T. Schär Kathleen Seidel |
| author_facet | Christopher Marvin Jesse Pablo Alvarez Abut Jonathan Wermelinger Andreas Raabe Ralph T. Schär Kathleen Seidel |
| author_sort | Christopher Marvin Jesse |
| collection | DOAJ |
| description | Data on intraoperative neurophysiological monitoring (IOM) during spinal meningioma (SM) surgery are scarce. The aim of this study was to assess the role of IOM and its impact on post-operative functional outcome. Eighty-six consecutive surgically treated SM patients were included. We assessed pre and post-operative Modified McCormick Scale (mMCS), radiological and histopathological data and IOM findings. Degree of cord compression was associated with preoperative mMCS and existence of motor or sensory deficits (<i>p</i> < 0.001). IOM was used in 51 (59.3%) patients (IOM-group). Median pre and post-operative mMCS was II and I, respectively (<i>p</i> < 0.001). Fifty-seven (66.3%) patients showed an improvement of at least one grade in the mMCS one year after surgery. In the IOM group, only one patient had worsened neurological status, and this was correctly predicted by alterations in evoked potentials. Analysis of both groups found no significantly better neurological outcome in the IOM group, but IOM led to changes in surgical strategy in complex cases. Resection of SM is safe and leads to improved neurological outcome in most cases. Both complication and tumor recurrence rates were low. We recommend the use of IOM in surgically challenging cases, such as completely ossified or large ventrolateral SM. |
| first_indexed | 2024-03-09T04:37:59Z |
| format | Article |
| id | doaj.art-53cf4a4d56724d908c19f60e113980d6 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T04:37:59Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-53cf4a4d56724d908c19f60e113980d62023-12-03T13:25:22ZengMDPI AGCancers2072-66942022-08-011416398910.3390/cancers14163989Functional Outcome in Spinal Meningioma Surgery and Use of Intraoperative Neurophysiological MonitoringChristopher Marvin Jesse0Pablo Alvarez Abut1Jonathan Wermelinger2Andreas Raabe3Ralph T. Schär4Kathleen Seidel5Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, SwitzerlandDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, SwitzerlandDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, SwitzerlandDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, SwitzerlandDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, SwitzerlandDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, SwitzerlandData on intraoperative neurophysiological monitoring (IOM) during spinal meningioma (SM) surgery are scarce. The aim of this study was to assess the role of IOM and its impact on post-operative functional outcome. Eighty-six consecutive surgically treated SM patients were included. We assessed pre and post-operative Modified McCormick Scale (mMCS), radiological and histopathological data and IOM findings. Degree of cord compression was associated with preoperative mMCS and existence of motor or sensory deficits (<i>p</i> < 0.001). IOM was used in 51 (59.3%) patients (IOM-group). Median pre and post-operative mMCS was II and I, respectively (<i>p</i> < 0.001). Fifty-seven (66.3%) patients showed an improvement of at least one grade in the mMCS one year after surgery. In the IOM group, only one patient had worsened neurological status, and this was correctly predicted by alterations in evoked potentials. Analysis of both groups found no significantly better neurological outcome in the IOM group, but IOM led to changes in surgical strategy in complex cases. Resection of SM is safe and leads to improved neurological outcome in most cases. Both complication and tumor recurrence rates were low. We recommend the use of IOM in surgically challenging cases, such as completely ossified or large ventrolateral SM.https://www.mdpi.com/2072-6694/14/16/3989spinal meningiomameningiomaintraoperative neurophysiological monitoringIDEMMcCormick scalefunctional outcome |
| spellingShingle | Christopher Marvin Jesse Pablo Alvarez Abut Jonathan Wermelinger Andreas Raabe Ralph T. Schär Kathleen Seidel Functional Outcome in Spinal Meningioma Surgery and Use of Intraoperative Neurophysiological Monitoring Cancers spinal meningioma meningioma intraoperative neurophysiological monitoring IDEM McCormick scale functional outcome |
| title | Functional Outcome in Spinal Meningioma Surgery and Use of Intraoperative Neurophysiological Monitoring |
| title_full | Functional Outcome in Spinal Meningioma Surgery and Use of Intraoperative Neurophysiological Monitoring |
| title_fullStr | Functional Outcome in Spinal Meningioma Surgery and Use of Intraoperative Neurophysiological Monitoring |
| title_full_unstemmed | Functional Outcome in Spinal Meningioma Surgery and Use of Intraoperative Neurophysiological Monitoring |
| title_short | Functional Outcome in Spinal Meningioma Surgery and Use of Intraoperative Neurophysiological Monitoring |
| title_sort | functional outcome in spinal meningioma surgery and use of intraoperative neurophysiological monitoring |
| topic | spinal meningioma meningioma intraoperative neurophysiological monitoring IDEM McCormick scale functional outcome |
| url | https://www.mdpi.com/2072-6694/14/16/3989 |
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