ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Reversible intraoperative neuromonitoring changes in thoracic ossification of the posterior longitudinal ligament and/or ossification of the ligamentum flavum surgery.
Article 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 6 papers.
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Who cites it
6 citing papers in PubMed.
- Effects of dexmedetomidine combined with erector spinae plane block on intraoperative neuromonitoring during surgical correction for adult spinal deformity.Scientific reports · 2025Trial
- Spinal cord shape factor as a predictor of postoperative functional outcome in thoracic ossification of the posterior longitudinal ligament.Spinal cord · 2026Article
- Letter to the Editor Re: "Reversible intraoperative neuromonitoring changes in thoracic ossification of the posterior longitudinal ligament and/or ossification of the ligamentum flavum surgery" by Liu et al. (Eur Spine J [2025]: DOI: 10.1007/s00586-025-09100-8).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 · 2026Article
- Diagnostic test accuracy meta-analysis of transcranial motor evoked potential monitoring for the prediction of postoperative neurological deficits in ossification of the posterior longitudinal ligament surgery.Clinical neurophysiology practice · 2026Review
- Perspective/short review: Mandatory intraoperative neurological monitoring (IONM) for thoracic ossification of the posterior longitudinal ligament (OPLL).Surgical neurology international · 2026Review
- Association between intraoperative hypotension and motor evoked potential change in ossification of posterior longitudinal ligament and/or ossification of ligamentum flavum surgery.North American Spine Society journal · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
objectiveWe aim to determine the surgical outcomes in patients with thoracic ossification of the posterior longitudinal ligament (OPLL) and/or ossification of the ligamentum flavum (OLF) who experienced intraoperative somatosensory- and/or motor-evoked potential (SSEP and/or MEP) changes.
methodsPatients who diagnosed with OPLL and/or OLF were identified. SSEP/MEP signals were acquired at two time-points: (1) during the maximal signal change and (2) 20 min after the change. Manual muscle testing (MMT) and the modified Japanese Orthopedic Association Scoring System (mJOA) were obtained to assess perioperative spinal neurological function.
resultsOf the 165 eligible patients, 104 experienced SSEP/MEP changes. These patients were stratified into two subgroups: 22 patients exhibited persistent signal changes, while 82 patients showed partial or complete signal recovery within 20 min after the maximum change. Patients with reversible SSEP/MEP changes had comparable surgical outcomes to those in the no-change group, including estimated blood loss ( 463 ±145 ml vs. 486±162 ml, p = 0.47) and operative time (205 ± 28 min vs. 213 ± 27 min, p = 0.81). Furthermore, postoperative spinal neurological function in patients with reversible change was similar to those of the no-change group in terms of short-term postoperative motor deficit (PMD) cases (reversible group: n = 4; no-change group: n = 2; p = 0.64 ) and long-term mJOA recovery ratio (RR) (reversible change group: 29.19% ± 9.76%; no-change group: 31.22% ± 13.91%; p = 0.21).
conclusionsReversible signals provide surgeons with confidence to complete the surgery safely, with surgical outcomes comparable to those of patients who do not experience SSEP/MEP changes.
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