ArticleAsian spine journal2021
Neuromonitoring in Cervical Spine Surgery: When Is a Signal Drop Clinically Significant?
Article in Asian spine journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Intraoperative neuromonitoring in degenerative cervical myelopathy surgery: a systematic review and meta-analysis of diagnostic accuracy and postoperative neurological outcomes.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Pooled it
- Predicting neurological outcomes following spinal surgery: A machine learning approach using intraoperative neuromonitoring data.North American Spine Society journal · 2026Article
- Feasibility of a Modified Wake-Up Test Without Intraoperative Neurophysiological Monitoring in Scoliosis Surgery: A Case Series.Case reports in anesthesiology · 2026Article
- Is it ethically permissible to allow untrained practitioners to perform IONM? An African perspective.Brain & spine · 2026Article
- Evaluating the predictive value of multimodal intraoperative neuromonitoring in anterior cervical discectomy and fusion: a retrospective cohort study on 442 patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Observational
- Assessment of Neurophysiological Parameters During Anterior Cervical Discectomy and Fusion and Their Correlation with Clinical Findings.Journal of clinical medicine · 2025Article
- Risk Factors and Exit Strategy of Intraoperative Neurophysiological Monitoring Alert During Deformity Correction for Adolescent Idiopathic Scoliosis.Global spine journal · 2024Article
- The Use of Intraoperative Neuromonitoring for Cervical Spine Surgery: Indications, Challenges, and Advances.Journal of clinical medicine · 2023Review
- Surgical Causes of Significant Intraoperative Neuromonitoring Signal Changes in Three-Column Spinal Surgery.Asian spine journal · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designRetrospective cohort study. PURPOSE: To identify the clinical significance of different patterns of intraoperative neuromonitoring (IONM) signal alerts. OVERVIEW OF LITERATURE: IONM is a long-established valuable adjunct to complex spine surgeries. IONM for cervical spine surgery is in the form of somatosensory evoked potential (SSEP) and motor evoked potential (MEP). The efficacy of both modalities (individually or in combination) to detect clinically significant neurological compromise is constantly being debated and requires conclusive suggestions.
methodsClinical and neuromonitoring data of 207 consecutive adult patients who underwent cervical spine surgeries at multiple surgical centers using bimodal IONM were analyzed. Signal changes were divided into three groups. Group 0 had transient signal changes in either MEPs or SSEPs, group 1 had sustained unimodal changes, and group 2 had sustained changes in both MEPs and SSEPs. The incidences of true neurological deficits in each group were recorded.
resultsA total of 25% (52/207) had IONM signal alerts. Out of these signal drops, 96% (50/52) were considered to be false positives. Groups 0 and 1 had no incidence of neurological deficits, while group 2 had a 29% (2/7) rate of true neurological deficits. The sensitivities of both MEP and SSEP were 100%. SSEP had a specificity of 96.6%, while MEP had a lower specificity at 76.6%. C5 palsy rate was 6%, and there was no correlation with IONM signal alerts (p=0.73).
conclusionsThis study shows that we can better predict its clinical significance by dividing IONM signal drops into three groups. A sustained, bimodal (MEP and SSEP) signal drop had the highest risk of true neurological deficits and warrants a high level of caution. There were no clear risk factors for false-positive alerts but there was a trend toward patients with cervical myelopathy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.