Observational studyEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Evaluating the predictive value of multimodal intraoperative neuromonitoring in anterior cervical discectomy and fusion: a retrospective cohort study on 442 patients.
Observational study in 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 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
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Perioperative antithrombotic management in degenerative spine surgery: a multicenter cohort of 767 consecutive patients.Frontiers in medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesAnterior cervical discectomy and fusion (ACDF) is a widely regarded surgical technique for the management of cervical disc herniation (CDH) and myelopathy, offering significant therapeutic efficacy. However, the potential for neurological complications persists, underscoring the need for strategies to enhance procedural safety. Multimodal intraoperative neuromonitoring (IONM) has emerged as a promising adjunct, providing real-time assessment of neural integrity to identify and address intraoperative compromise. This study seeks to rigorously assess the diagnostic accuracy of IONM in ACDF, evaluate its predictive utility for postoperative neurological outcomes, and analyze its association with intraoperative neural events.
methodsThis monocentric retrospective observational study analyzed CDH patients who underwent ACDF between 2014 and 2023. Neurological status was pre- and postoperatively assessed and compared to IONM data, including somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), and electromyography (EMG) alarms. IONM diagnostic performance was analyzed using confusion matrices and ROC curves on the binary variables. Multivariate logistic regression was implemented to identify predictors of postoperative neurological decline.
resultsSSEPs and MEPs demonstrated high diagnostic accuracy, with ROC curve areas improving significantly from preoperative (T0) to postoperative (T1) assessments (SSEP AUC: 0.922 to 1.000; MEP AUC: 0.915 to 0.996, p < 0.01). Among 442 consecutive patients, 38 (9%) intraoperative IONM alerts were recognized, labeled as transient, sustained single-modality, or sustained dual-modality changes. Permanent neurological injuries correlated with alert severity. Intraoperative alarms were the strongest predictor of postoperative motor deficits (OR:14.0, p < 0.01).
conclusionMultimodal IONM demonstrated significant predictive value for postoperative neurological outcomes in ACDF, with intraoperative alerts strongly correlating with motor deficits. IONM was associated with postoperative neurological outcomes, suggesting a potential role in selected high-risk patients. Further studies are warranted to assess cost-effectiveness and define standardized indications.
Indexed as
Identifiers
40442520What 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.