The prognostic value of transcranial electrical stimulation in cervicaldisc herniation surgery with non-myelopathic evidence: A systematic review

ISSN: 2449-1942 Vol. 3 (1), pp. 047-050, February, 2015. 

Review

The prognostic value of transcranial electrical stimulation in cervicaldisc herniation surgery with non-myelopathic evidence: A systematic review.

Fotakopoulos George1*Vagkopoulos Konstantinos1, Kotlia Polikceni2, Panagiotopoulos Vasilios3Fountas Kostas1

1Department of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Building A, 3rd Floor, Biopolis, Larisa, 41110, Greece.

2Department of Anesthesiology and critical care medicine, University Hospital of  Patras medical school, Patra, Greece

3Department of Neurosurgery, University Hospital of Patras medical school, Patra, Greece 

*Corresponding author. Email: gfotakop@yahoo.gr, Tel.: +30 2621051828 

Accepted 29 January, 2015 

Abstract

The study was to evaluate the prognostic value of Transcranial electrical stimulation (TES): including transcranial motor evoked potentials (TcMEPs) and continuous free running electromyography (EMG) monitoring, with the literature review, during anterior cervical discectomy and fusion (ACDF) in cervical disc herniation surgery with non-myelopathic evidence. Methods and results: This is a review articlefrom the 1211 related articles at PubMed search andthe exact search was done using the term - Cervical and Intraoperative monitoring - (last updated on the 15 November 2013). This study investigates one hundred and ninety two (192) patients (97 male and 95 female) (1, 5, 22).The mean age was 47.95 ± 13.95, range: 3–84 years. Fourteen nine (49) were eligible for inclusion undergoing ACDF the treatment of cervical radiculopathy due to CDH with non-myelopathic evidence. A 41-50 % increase in TcMEP amplitude was the threshold for the discrimination of patients with excellent (Odom’s scale I) postoperative outcome. When the increase of TcMEP amplitude was ≤ 10-11% the patient’s outcome was fair. The pain was assessed preoperative and postoperative according to visual analog score (VAS). The present study considering the literature review, investigates the prognostic value of TES during ACDF in cervical disc herniation surgery with non-myelopathic evidence. TES not only ensure the neural structure integrity preventing intraoperative damages, but also may become an important instrument to a better clinical management.The possibility of getting clinical outcome information immediately after the procedure, may add to TES an important prognostic value along with the ensuring of the neural structure integrity.

Keywords: Cervical disc hearniation, intraoperative monitoring, MEP