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. 2025 Feb 28:18:1155-1161.
doi: 10.2147/IJGM.S495371. eCollection 2025.

Application of Neurophysiological Monitoring and Ultrasound Guidance in Intramedullary Decompression for Acute Spinal Cord Injury

Haoyuan Wang #  1   2 , Zhao Chen #  1 , Xianxiang Wang  1 , Yiquan Zhang  1 , Hui Wang  1 , Ke Zhang  1
Affiliations

Application of Neurophysiological Monitoring and Ultrasound Guidance in Intramedullary Decompression for Acute Spinal Cord Injury

Haoyuan Wang et al. Int J Gen Med. .

Abstract

Objective: To explore the clinical application value of neurophysiological monitoring combined with ultrasound guidance in Acute spinal cord injury.

Methods: Ten patients with acute spinal cord injury underwent intramedullary decompression surgery under neurophysiological monitoring and intraoperative ultrasound guidance. ASIA (American Spinal Injury Association) classification and JOA (Japan Orthopaedic Association) scoring were performed preoperatively and postoperatively.

Results: The preoperative, 1-week postoperative, and 1-year postoperative JOA scores for the ten patients were (6.2 ± 1.55), (7 ± 1.58), and (11.8 ± 1.60), respectively. The JOA improvement rates at 1 week and 1 year postoperation were 7.4% and 51.9%, respectively. Among the patients, one patient had severe thoracic spinal cord injury upon admission, and their ASIA classification remained at Grade A after 1 year postoperation, while the remaining nine patients showed varying degrees of neurological function improvement.

Conclusion: Intraoperative neurophysiological monitoring combined with intraoperative ultrasound not only allows for timely monitoring of spinal cord function but also enables observation of whether decompression is adequate during surgery. It represents a very good surgical option for patients with spinal cord injuries.

Keywords: acute spinal cord injury; intramedullary decompression surgery; intraoperative ultrasound; neurophysiological monitoring.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Intraoperative ultrasound imaging and comparison of preoperative and postoperative MRI examinations. The intraoperative ultrasound image shows the restoration of spinal cord morphology to normal in the sagittal plane (A) and axial plane (B) after decompression surgery. (C-D) displays a comparison of preoperative and postoperative magnetic resonance images (Arrows indicate the injured site).
Figure 2
Figure 2
Intraoperative electrophysiological changes before and after decompression: (A) shows the change in somatosensory evoked potentials before and after decompression, with no significant waveform changes observed; (B) shows the change in motor evoked potentials before and after decompression, with a significant increase in amplitude.
See this image and copyright information in PMC

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