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- Fioravante Capone, Francesco Ciro Tamburelli, Fabio Pilato, Paolo Profice, Federico Ranieri, Riccardo Di Iorio, Francesco Iodice, Gabriella Musumeci, and Vincenzo Di Lazzaro.
- Institute of Neurology, Campus BioMedico University, Via Alvaro del Portillo 200, 00128 Rome, Italy; Fondazione Alberto Sordi - Research Institute for Ageing, Via Álvaro del Portillo 5, 00128 Rome, Italy. Electronic address: fiorecapone@virgilio.it.
- Spine J. 2013 Sep 1; 13 (9): 1077-9.
Background ContextCervical spondylotic myelopathy (CSM) is a common disorder, but its management and the role of surgery are still a matter of controversy. The assessment of surgical outcome is complicated by the lack of reliable and objective methods to assess the severity of the myelopathy and its evolution. Motor-evoked potentials (MEPs) are a useful and reliable tool to measure noninvasively the involvement of the corticospinal tract in patients with CSM. Recent evidence suggests that MEPs could also have a role in monitoring the effect of surgical therapy.PurposeThe aim of the present study is to use MEPs for the functional assessment of spinal cord before and after surgery and to correlate changes in MEPs with clinical findings.Study Design/SettingThis is a retrospective cohort study.Patient SampleThirty-eight patients affected by CSM who underwent surgical intervention.Outcome MeasuresWe used the 18-point modified Japanese Orthopedic Association (mJOA) score for clinical evaluation and the central motor conduction time (CMCT) for the study of MEPs.MethodsAll patients were evaluated both clinically and neurophysiologically before (7-15 days) and after (6-12 months) surgery. MEPs were recorded from the biceps, abductor digiti minimi, and tibialis anterior muscles bilaterally.ResultsAfter surgery, the 18-point mJOA score increased significantly from 10.1 to 15.1, and the value of CMCT for tibialis anterior muscles showed a slight but significant reduction, more evident in patients with mild to moderate symptoms.ConclusionsEarly surgical intervention for CSM could produce a beneficial effect on spinal cord functionality that can be detected by MEPs.Copyright © 2013 Elsevier Inc. All rights reserved.
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