The value of somatosensory and motor-evoked potentials in predicting and monitoring the effect of therapy in spondylotic cervical myelopathy. (Prospective randomised study).
|Year of publication||1999|
|Type||Article in Periodical|
|Magazine / Source||Spine|
|MU Faculty or unit|
|Field||Neurology, neurosurgery, neurosciences|
|Keywords||Spondylotic cervical myelopathy;somatosensory evoked potentials;motor evoked potentials|
|Description||Study design. A two-year follow-up prospective randomised electrophysiological and clinical study was performed in patients with spondylotic cervical myelopathy. Objective. To assess the value of somatosensory (SEP) and motor evoked potentials (MEP) in the evaluation and prediction of the effect of therapy. Summary of background data. Previous studies have yielded conflicting data concerning the correlation between the changes in evoked potential parameters and the clinical post-surgical outcome in spondylotic cervical myelopathy (SCM). Methods. Sixty-one patients with magnetic resonance imaging (MRI) signs of spondylotic cervical cord compression and clinical signs of cervical myelopathy were divided into two groups according to the degree of clinical cervical cord involvement. Forty-nine patients with mild and moderate SCM were randomised into groups that underwent either surgical or conservative therapy. Patients were evaluated clinically and by the means of SEP and MEP. Results. 1. The clinical and evoked potential (EP) changes showed good correlation as a group, but poor correlation intra-individually. 2. There were no significant EP and clinical group changes after 6 months and 2 years in mild myelopathy group treated either surgically and conservatively, while patients with severe myelopathy displayed significant improvement in both clinical and EP parameters after surgery. 3. In a subgroup of patients the isolated segmental medullar N 13 abnormality predicted favourable post-surgical clinical outcome. Conclusions. Longitudinal EPs showed limited utility in the evaluation of the results of therapy in an individual patient. They could be useful in the group assessment of the results of therapy and in labelling a subgroup of patients with potentially favourable post-surgical outcome.|