Comparing SSEPs and MRI as Diagnostic Tools for Evaluating Compressive Myelopathies Caused by Disc Herniation

Authors

  • Haneen J. Mohammed Basrah health directorate, Basrah, Iraq
  • Farah N. Abbas Department of Physiology, College of Medicine, University of Babil, Babil, Iraq.
  • Mazin M. Hammady Department of Internal Medicine, College of Medicine, University of Basrah, Basrah, Iraq

DOI:

https://doi.org/10.62480/tjms.2023.vol18.pp95-101

Keywords:

SSEPs, spine MRI, Electrodiagnostics, compressive myelopathy

Abstract

Compressive myelopathy is a neurological deficit that results from compression of the spinal cord and leads to a variety of symptoms and potentially serious consequences. Magnetic resonance imaging (MRI) is the gold standard for diagnosing compressive myelopathy as it provides high-resolution anatomical images and is the preferred method for evaluating the underlying pathology, but somatosensory evoked potentials (SSEPs) have also been used as a diagnostic tool as it provides information about the functional integrity of the spinal cord and assess the severity and extent of the damage. This article presents a comparative analysis of MRI and SSEPs in the diagnosis of compressive myelopathy and discusses the complementary role they can play in diagnosis and monitoring of the disease. Seventy four subjects were involved in the study, divided into controls (35) and cases (39) of myelopathies due to disc herniation. Severity of myelopathy for cases group were classified according to modified Japanese Assessment scale (mJOA) into; mild, moderate and severe. SSEPs showed more correlation with severity of myelopathy more than MRI (r=0.948, 0.599 respectively) and higher sensitivity of SSEPs for detecting severe myelopathies (91.7%) while MRI sensitivity was only (16.7%) sensitive.

References

Diseases & pathophysiology in neurology. Huppert L.A., & Dyster T.G.(Eds.), (2021). Huppert’s Notes: Pathophysiology and Clinical Pearls for Internal Medicine. McGraw Hill.

Kranz, P.G. and Amrhein, T.J. 2019. Imaging Approach to Myelopathy: Acute, Subacute, and Chronic. Radiol Clin North Am. Mar; 57(2):257-279.

Expert Panel on Neurological Imaging, Agarwal, V., Shah, L. M., Parsons, M. S., Boulter, D. J., Cassidy, R. C., Hutchins, T. A., Jamlik-Omari Johnson, Kendi, A. T., Khan, M. A., Liebeskind, D. S., Moritani, T., Ortiz, A. O., Reitman, C., Shah, V. N., Snyder, L. A., Timpone, V. M., & Corey, A. S. (2021). ACR Appropriateness Criteria® Myelopathy: 2021 Update. Journal of the American College of Radiology, 18(5S), S73–S82.

Muzyka, I.M. and Estephan, B., 2019. Somatosensory evoked potentials. Handb Clin Neurol.;160:523-540.

Zileli, M., Maheshwari, S., Kale, S.S., Garg, K., Menon, S.K., Parthiban, J., 2019. Outcome Measures and Variables Affecting Prognosis of Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations. Neurospine, 16(3), pp.435-447.

Tetreault, L., Kopjar, B., Nouri, A. et al. The modified Japanese Orthopaedic Association scale: establishing criteria for mild, moderate and severe impairment in patients with degenerative cervical myelopathy. Eur Spine J 26, 78–84 (2017).

Zileli M, Maheshwari S, Kale SS, Garg K, Menon SK, Parthiban J. Outcome Measures and Variables Affecting Prognosis of Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations. Neurospine. 2019 Sep;16(3):435-447.

Nouri A, Tetreault L, Singh A, Karadimas SK, Fehlings MG. Degenerative Cervical Myelopathy: Epidemiology, Genetics, and Pathogenesis. Spine (Phila Pa 1976). 2015 Jun 15;40(12):E675-93.

Van den Brand, R., Heutschi, J., Barraud, Q., DiGiovanna, J., Bartholdi, K., Huerlimann, M., et al,. 2012. Restoring voluntary control of locomotion after paralyzing spinal cord injury. Science (New York, N.Y.), 336(6085), pp. 1182–1185.

Leemhuis, E., Favieri, F., Forte, G., Pazzaglia, M., 2022. Integrated Neuroregenerative Techniques for Plasticity of the Injured Spinal Cord. Biomedicines.; 10(10):2563.

Janardhana, A. P., Rajagopal, Rao.S., and Kamath, A. 2010. Correlation between clinical features and magnetic resonance imaging findings in lumbar disc prolapse. Indian journal of orthopaedics, 44(3), pp. 263–269.

Kareem, R. M., Al-madfai, Z. and A. Al-Sheikhly, A., 2014. “Somatosensory Evoked Potentials Study in Cervical Spondylotic Myelopathy Patients”, Journal of the Faculty of Medicine Baghdad, 56(1), pp. 101–106.

Feng, X., Hu, Y., and Ma, X. 2020. Progression Prediction of Mild Cervical Spondylotic Myelopathy by Somatosensory-evoked Potentials. Spine, 45(10), pp.560–567.

Nardone, R., Höller, Y., Brigo, F., Frey, V.N., Lochner, P., Leis, S., Golaszewski, S., Trinka, E. et al., 2016. The contribution of neurophysiology in the diagnosis and management of cervical spondylotic myelopathy: a review. Spinal Cord, 54, pp. 756–766

Downloads

Published

2023-03-26

Issue

Vol. 18 (2023): TJMS

Section

Articles

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

User Rights

Under the Creative Commons Attribution-NonCommercial 4.0 International (CC-BY-NC), the author (s) and users are free to share (copy, distribute and transmit the contribution).

Rights of Authors

Authors retain the following rights:
1. Copyright and other proprietary rights relating to the article, such as patent rights,
2. the right to use the substance of the article in future works, including lectures and books,
3. the right to reproduce the article for own purposes, provided the copies are not offered for sale,
4. the right to self-archive the article.

How to Cite

Comparing SSEPs and MRI as Diagnostic Tools for Evaluating Compressive Myelopathies Caused by Disc Herniation. (2023). Texas Journal of Medical Science, 18, 95-101. https://doi.org/10.62480/tjms.2023.vol18.pp95-101