AI Article Synopsis
- Degenerative cervical myelopathy is a leading cause of disability in older adults, and surgical decompression is the recommended treatment for symptomatic patients; our study utilized navigated transcranial magnetic stimulation (nTMS) to assess how this surgery impacts neurophysiology and clinical recovery.
- We conducted a study with 15 patients, measuring nTMS neurophysiological indexes and clinical scores before surgery and then at 6 and 12 months post-surgery, finding significant improvements in motor function and neurophysiological metrics.
- Results indicated that surgical decompression enhances neurophysiological function in the spinal cord and cortex, leading to meaningful recovery, supporting the idea that the brain and spinal cord can undergo functional changes and plasticity.
Article Abstract
(1) Background: Degenerative cervical myelopathy is one of the main causes of disability in the elderly. The treatment of choice in patients with clear symptomatology and radiological correlation is surgical decompression. The application of navigated transcranial magnetic stimulation (nTMS) techniques has the potential to provide additional insights into the cortical and corticospinal behavior of the myelopathic cord and to better characterize the possible extent of clinical recovery. The objective of our study was to use nTMS to evaluate the effect of surgical decompression on neurophysiological properties at the cortical and corticospinal level and to better characterize the extent of possible clinical recovery. (2) Methods: We conducted a longitudinal study in which we assessed and compared nTMS neurophysiological indexes and clinical parameters (modified Japanese Orthopedic Association score and nine-hole pegboard test) before surgery, at 6 months, and at 12 months' follow-up in a population of 15 patients. (3) Results: We found a significant reduction in resting motor threshold (RMT; average 7%), cortical silent period (CSP; average 15%), and motor area (average 25%) at both 6 months and 12 months. A statistically significant linear correlation emerged between recruitment curve (RC) values obtained at follow-up appointments and at baseline (r = 0.95 at 6 months, r = 0.98 at 12 months). A concomitant improvement in the mJOA score and in the nine-hole pegboard task was observed after surgery. (4) Conclusions: Our results suggest that surgical decompression of the myelopathic spinal cord improves the neurophysiological balance at the cortical and corticospinal level, resulting in clinically significant recovery. Such findings contribute to the existing evidence characterizing the brain and the spinal cord as a dynamic system capable of functional and reversible plasticity and provide useful clinical insights to be used for patient counseling.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10887348 | PMC |
| http://dx.doi.org/10.3390/brainsci14020124 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Innovative technique of corking the lumen of an intraoperatively decompressed turgid gall bladder with surgical gauze to prevent gall bladder stone/bile spillage during a laparoscopic cholecystectomy.
J Minim Access Surg
January 2025
Department of Minimal Access, GI, Bariatric and Robotic Surgery, Apollo Speciality Hospital, Bengaluru, Karnataka, India.
Technical difficulties are often encountered in a laparoscopic cholecystectomy where a tense/distended/ turgid gall bladder prevents the surgeon from grasping the gall bladder properly which therefore necessitates the decompression of the turgid gall bladder. However, even if intraoperative decompression is done, the spillage of remnant stones, bile or fluid from the gall bladder is a possibility which can lead to undue complications. This is where following the simple technique of using a gauze piece with a radio-opaque marker to occlude the decompression puncture site helps in performing a safe decompression thereby preventing bile, fluid or stone spillage.
View Article and Find Full Text PDFRevisiting the place of surgical portal decompression for adults with noncirrhotic portal hypertension due to chronic extrahepatic portal vein obstruction: a scoping review.
HPB (Oxford)
January 2025
Hepato-Biliary Center, AP-HP Paul Brousse Hospital, Paris-Saclay University, INSERM Unit 1193, 94800 Villejuif, France. Electronic address:
Background: Liver cirrhosis accounts for more than 90 % of portal hypertension cases, and the other cases are due to noncirrhotic portal hypertension (NCPH). Variceal bleeding is the most life-threatening complication of portal hypertension and its primary treatment is medical according to the Baveno VII guidelines. This review discusses the evidence on surgical portal decompression for adult patients with NCPH secondary to chronic extrahepatic portal vein obstruction (EHPVO).
View Article and Find Full Text PDFOsteonecrosis of the Humerus: Trends in Surgical Management of a Nationwide Sample From 2010 to 2021.
J Shoulder Elbow Surg
January 2025
Maimonides Medical Center, Department of Orthopaedic Surgery and Rehabilitation, Brooklyn, NY, USA.
Introduction: The humeral head is the second most common site for osteonecrosis but its epidemiology is poorly described. This study aimed to better understand its treatment in the United States by 1) evaluating total operative procedures with rates normalized to the annual surgical volume; 2) determining trends of non-joint preserving (shoulder arthroplasty) vs. joint preserving procedures; and 3) quantifying rates of operative techniques in different aged cohorts (<50 vs.
View Article and Find Full Text PDFRegional Anesthesia with Spontaneous Breathing for Trans-Axillary Surgery in Thoracic Outlet Syndrome: A Retrospective Comparative Study.
J Clin Med
January 2025
Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy.
Thoracic outlet syndrome (TOS) is an uncommon condition defined by the compression of neurovascular structures within the thoracic outlet. When conservative management strategies fail to alleviate symptoms, surgical decompression becomes necessary. The purpose of this study is to evaluate and compare the efficacy and safety of regional anesthesia (RA) using spontaneous breathing in contrast to general anesthesia (GA) for patients undergoing surgical intervention for TOS.
View Article and Find Full Text PDFPathogenesis, Diagnosis, and Management of Trigeminal Neuralgia: A Narrative Review.
J Clin Med
January 2025
Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China.
Trigeminal neuralgia (TN) is an excruciating neurological disorder characterized by intense, stimulus-induced, and transient facial stabbing pain. The classification of TN has changed as a result of new discoveries in the last decade regarding its symptomatology, pathogenesis, and management. Because different types of facial pain have different clinical therapy and neuroimaging interpretations, a precise diagnosis is essential.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!