Intraoperative neurophysiological monitoring and patient-related outcomes in thoracic spinal meningiomas surgery: a single-center retrospective cohort study.

Abstract

The aim of this study was to evaluate the relationships between changes in intraoperative neurophysiological monitoring (IONM) and patient-related outcomes (PROs), by Brief Pain Inventory (BPI) questionnaire and the MD Anderson Symptom Inventory (MDASI) questionnaire, in a cohort of patients operated on for thoracic spinal meningioma (SM). This is a retrospective study on patients operated on for thoracic SMs in whom IONM was used. BPI and the MDASI were recorded preoperatively, at 1-month, 6- and 12-month follow-up. The Wilcoxon signed-rank test was used to evaluate significant differences between preoperative and postoperative individual items from the MDASI, BPI, and neurological dysfunction through the modified McCormick scale (mMCS). To compare differences in outcome measures, repeated measures ANOVA were performed. Spearman's rank-order correlation was used to analyze the degree of association between the variables after surgery. Statistical significance was set at p < 0.05. A total of 183 patients operated on for thoracic SM were included. Of these, 95 (52%) had no change in IONMs during surgery, 30 (16%) had a worsening in motor, sensory, or mixed recordings, and 58 (32%) had an improvement in intraoperative recordings. Both the MDASI and BPI showed a statistically significant improvement from the baseline to the first follow-up (p > 0.001), remaining stable over time. In our series, we observed statistical significance differences between favorable IONM, neurological outcome, and PROs. Further studies with a larger sample size and a longer follow-up may provide more conclusive results.