Neurophysiological monitoring and postoperative efficacy of spine surgery: a meta-analysis
10.3760/cma.j.cn121113-20250314-00256
- VernacularTitle:脊柱外科手术术中神经生理学监测的有效性和安全性meta分析
- Author:
Yu LI
1
;
Dachuan WANG
1
Author Information
1. 山东第一医科大学附属省立医院脊柱外科，济南 250014
- Publication Type:Journal Article
- Keywords:
Spine;
Surgery;
Intraoperative neurophysiological monitoring;
Meta-analysis
- From:
Chinese Journal of Orthopaedics
2025;45(16):1059-1065
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the efficacy and safety of intraoperative neurophysiological monitoring (IONM) in spinal surgery.Methods:Clinical studies on the application of IONM in spinal surgery were retrieved from CNKI, VIP, Chinese Medical Journal Full-text Database, PubMed, and Web of Science, with the retrieval time ranging from January 2014 to March 2025. The incidence of intraoperative nerve injury, preoperative and postoperative Japanese Orthopaedic Association (JOA) score, and lesion clearance rate were collected. Meta-analysis was performed using Stata 18.0 statistical software. When the heterogeneity between groups was small, the fixed-effect model was used for analysis, and when the heterogeneity between groups was large, the random-effect model was used.Results:A total of 17 studies involving 1,865 patients were included in the meta-analysis. Among them, there were 13 Chinese literatures and 4 English literatures, 2 randomized controlled trials and 15 observational studies, all of which were of high quality. The results of meta-analysis showed that the incidence of intraoperative nerve injury in the monitoring group was lower than that in the non-monitoring group [ OR=0.52, 95% CI(0.37, 0.74), P<0.001]. There was no statistically significant difference in preoperative JOA scores between the two groups [ SMD=0.01, 95% CI(0.37, 0.74), P=0.971]. However, the postoperative JOA score in the monitoring-group was higher than the preoperative score, and the difference was statistically significant [ SMD=5.34, 95% CI(0.29, 10.39), P=0.038]. There was no statistically significant difference in JOA scores before and after surgery in the non-monitoring group [ SMD=3.51, 95% CI(-0.56, 7.59), P=0.091]. There was no statistically significant difference in lesion clearance rate between the two groups [ OR=1.17, 95% CI(0.88, 1.57), P=0.281]. Conclusion:The use of IONM in spinal surgery can reduce the incidence of intraoperative nerve injury and improve functional scores.
