Preoperative patient selection with magnetic resonance imaging, computed tomography, and electroencephalography: Does the test predict outcome after cervical surgery?

Praveen V. Mummaneni, Michael G. Kaiser, Paul G. Matz, Paul A. Anderson, Michael Groff, Robert Heary, Langston Holly, Timothy Ryken, Tanvir Choudhri, Edward Vresilovic, Daniel Resnick

Research output: Contribution to journalReview article

37 Citations (Scopus)

Abstract

Object. The objective of this systematic review was to use evidence-based medicine to assess whether preoperative imaging or electromyography (EMG) predicts surgical outcomes in patients undergoing cervical surgery. Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to the preoperative imaging and EMG. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. Preoperative MR imaging and CT myelography are successful in confirming clinical radiculopathy (Class II). Multilevel T2 hyperintensity, T1 focal hypointensity combined with T2 focal hyperintensity, and spinal cord atrophy each convey a poor prognosis (Class III). There is conflicting data concerning whether focal T2 hyperintensity or cervical stenosis are associated with a worse outcome. Electromyography has mixed utility in predicting outcome (Class III). Conclusions. Magnetic resonance imaging or CT myelography are important for preoperative assessment. Magnetic resonance imaging may be helpful in assessing prognosis, whereas EMG has mixed utility in assessing outcome.

Original languageEnglish (US)
Pages (from-to)119-129
Number of pages11
JournalJournal of Neurosurgery: Spine
Volume11
Issue number2
DOIs
StatePublished - Aug 1 2009

Fingerprint

Electromyography
Patient Selection
Electroencephalography
Tomography
Magnetic Resonance Imaging
Myelography
Guidelines
Medical Subject Headings
National Library of Medicine (U.S.)
Radiculopathy
Peer Review
Evidence-Based Medicine
Atrophy
Spinal Cord
Consensus
Pathologic Constriction
Joints
Databases

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology

Cite this

Mummaneni, Praveen V. ; Kaiser, Michael G. ; Matz, Paul G. ; Anderson, Paul A. ; Groff, Michael ; Heary, Robert ; Holly, Langston ; Ryken, Timothy ; Choudhri, Tanvir ; Vresilovic, Edward ; Resnick, Daniel. / Preoperative patient selection with magnetic resonance imaging, computed tomography, and electroencephalography : Does the test predict outcome after cervical surgery?. In: Journal of Neurosurgery: Spine. 2009 ; Vol. 11, No. 2. pp. 119-129.
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abstract = "Object. The objective of this systematic review was to use evidence-based medicine to assess whether preoperative imaging or electromyography (EMG) predicts surgical outcomes in patients undergoing cervical surgery. Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to the preoperative imaging and EMG. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. Preoperative MR imaging and CT myelography are successful in confirming clinical radiculopathy (Class II). Multilevel T2 hyperintensity, T1 focal hypointensity combined with T2 focal hyperintensity, and spinal cord atrophy each convey a poor prognosis (Class III). There is conflicting data concerning whether focal T2 hyperintensity or cervical stenosis are associated with a worse outcome. Electromyography has mixed utility in predicting outcome (Class III). Conclusions. Magnetic resonance imaging or CT myelography are important for preoperative assessment. Magnetic resonance imaging may be helpful in assessing prognosis, whereas EMG has mixed utility in assessing outcome.",
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Mummaneni, PV, Kaiser, MG, Matz, PG, Anderson, PA, Groff, M, Heary, R, Holly, L, Ryken, T, Choudhri, T, Vresilovic, E & Resnick, D 2009, 'Preoperative patient selection with magnetic resonance imaging, computed tomography, and electroencephalography: Does the test predict outcome after cervical surgery?', Journal of Neurosurgery: Spine, vol. 11, no. 2, pp. 119-129. https://doi.org/10.3171/2009.3.SPINE08717

Preoperative patient selection with magnetic resonance imaging, computed tomography, and electroencephalography : Does the test predict outcome after cervical surgery? / Mummaneni, Praveen V.; Kaiser, Michael G.; Matz, Paul G.; Anderson, Paul A.; Groff, Michael; Heary, Robert; Holly, Langston; Ryken, Timothy; Choudhri, Tanvir; Vresilovic, Edward; Resnick, Daniel.

In: Journal of Neurosurgery: Spine, Vol. 11, No. 2, 01.08.2009, p. 119-129.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Preoperative patient selection with magnetic resonance imaging, computed tomography, and electroencephalography

T2 - Does the test predict outcome after cervical surgery?

AU - Mummaneni, Praveen V.

AU - Kaiser, Michael G.

AU - Matz, Paul G.

AU - Anderson, Paul A.

AU - Groff, Michael

AU - Heary, Robert

AU - Holly, Langston

AU - Ryken, Timothy

AU - Choudhri, Tanvir

AU - Vresilovic, Edward

AU - Resnick, Daniel

PY - 2009/8/1

Y1 - 2009/8/1

N2 - Object. The objective of this systematic review was to use evidence-based medicine to assess whether preoperative imaging or electromyography (EMG) predicts surgical outcomes in patients undergoing cervical surgery. Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to the preoperative imaging and EMG. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. Preoperative MR imaging and CT myelography are successful in confirming clinical radiculopathy (Class II). Multilevel T2 hyperintensity, T1 focal hypointensity combined with T2 focal hyperintensity, and spinal cord atrophy each convey a poor prognosis (Class III). There is conflicting data concerning whether focal T2 hyperintensity or cervical stenosis are associated with a worse outcome. Electromyography has mixed utility in predicting outcome (Class III). Conclusions. Magnetic resonance imaging or CT myelography are important for preoperative assessment. Magnetic resonance imaging may be helpful in assessing prognosis, whereas EMG has mixed utility in assessing outcome.

AB - Object. The objective of this systematic review was to use evidence-based medicine to assess whether preoperative imaging or electromyography (EMG) predicts surgical outcomes in patients undergoing cervical surgery. Methods. The National Library of Medicine and Cochrane Database were queried using MeSH headings and keywords relevant to the preoperative imaging and EMG. Abstracts were reviewed after which studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations that contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons. Results. Preoperative MR imaging and CT myelography are successful in confirming clinical radiculopathy (Class II). Multilevel T2 hyperintensity, T1 focal hypointensity combined with T2 focal hyperintensity, and spinal cord atrophy each convey a poor prognosis (Class III). There is conflicting data concerning whether focal T2 hyperintensity or cervical stenosis are associated with a worse outcome. Electromyography has mixed utility in predicting outcome (Class III). Conclusions. Magnetic resonance imaging or CT myelography are important for preoperative assessment. Magnetic resonance imaging may be helpful in assessing prognosis, whereas EMG has mixed utility in assessing outcome.

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