title: Prognostic value of intraoperative MEP signal improvement during surgical treatment of cervical compressive myelopathy.
abstract: The purpose of the current study was to evaluate the prognostic value of intraoperative improved transcranial motor evoked potential (MEP) after cervical cord decompressive surgery for cervical compressive myelopathy (CCM).
  
  
  
  A consecutive series of 59 CCM patients who underwent cervical cord decompressive surgery were studied between December 2013 and April 2015 in this study. And all patients were divided into three subgroups: the patients with intraoperative improved MEP, without obvious MEP change and MEP degeneration. MEP and modified Japanese Orthopedic Association (mJOA) score were mainly utilized to assess intra-, pre- and post-operative neurologic function; all patients had reliable and stable MEP baseline. The early neurologic outcomes and the long-term mJOA improvement rate were evaluated after surgery.
  
  
  
  There were 21 patients with intraoperative monitoring improvement (MEP improved rate, 140 ± 76 %), 32 patients without obvious MEP change and six patients with MEP degeneration. The early motor or sensory outcome showed varying degrees of recovery in the MEP improvement group. The long-term mJOA improvement rate among the three groups was 59.5 ± 4.2, 48.9 ± 3.9 and 40.6 ± 7.4 %, respectively, after 6-month follow-up, and the improvement group was better than the other two groups with statistical significance (59.5 ± 4.2 vs. 48.9 ± 3.9 %, p < 0.05; 59.5 ± 4.2 vs. 40.6 ± 7.4, p < 0.05).
  
  
  
  Patients with intraoperative MEP improvement after cervical cord decompression have better prognosis in early and long-term neurologic recovery in CCM surgery.
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
authors.forename: Shujie
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China. pumchtianye@163.com.
authors.forename: Ye
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
authors.forename: Chu
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
authors.forename: Qianyu
authors.initials: Q
authors.lastname: Zhuang
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
authors.forename: Huiming
authors.initials: H
authors.lastname: Peng
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
authors.forename: Jianxiong
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
authors.forename: Xisheng
authors.initials: X
authors.lastname: Weng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D019299:Decompression, Surgical; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring; D007796:Laminectomy; D065406:Laminoplasty; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D013117:Spinal Cord Compression / Q000601:surgery*
keywords: Cervical compressive myelopathy (CCM); MEP improvement; MJOA improvement rate; Neurologic function recovery