Intraoperative Monitoring of CSF Pressure in Patients with Degenerative Cervical Myelopathy (COMP-CORD Study): A Prospective Cohort Study

• DOI: 10.1089/neu.2021.0310
• Publication Date: 2021-11-22T14:55:00Z
• Authors: Carl M. Zipser; Nikolai Pfender; Najmeh Kheram; Andrea Boraschi; José Aguirre; Nils H. Ulrich; José Miguel Spirig; Alexandre Ansorge; Michael Betz; Florian Wanivenhaus; Markus Hupp; Vartan Kurtcuoglu; Mazda Farshad; Armin Curt; Martin Schubert
• Keywords: Interquartile range

Degenerative cervical myelopathy (DCM) is hallmarked by spinal canal narrowing and related cord compression myelopathy. Cerebrospinal fluid (CSF) pressure dynamics are likely disturbed due to stenosis. The study aimed investigate the diagnostic value of continuous intraoperative CSF monitoring during surgical decompression. This prospective single center (NCT02170155) enrolled DCM patients who underwent decompression between December 2019 May 2021. Data from n = 17 were analyzed symptom severity graded with modified Japanese Orthopedic Score (mJOA). pulsations continuously monitored a lumbar intrathecal catheter Mean patient age was 62 ± 9 years (range 38-73; 8 female), symptoms mild-moderate in most (mean mJOA 14 2, range 10-18). Measurements well tolerated without safety concerns. In 15/16 (94%), increased at time one case, responsiveness could not be evaluated for technical reasons. Unexpected pulsation decrease adverse events (i.e., leakage). Median amplitudes pre-decompression (0.52 mm Hg, interquartile [IQR] 0.71) post-decompression (0.72 IQR 0.96; p 0.001). baseline lower magnitude than pulsations, 9.5 3.5 10.3 3.8 Hg (p 0.003). Systematic relations confined decompression, independent arterial blood 0.927) or heart rate 0.102). Intraoperative while addition discerned. Further investigation clinical guidance complex surgery promising.