The effects on the results of the application of intraoperative neuromonitarization techniques during intradural spinal surgery

Intradural Spinal Cord Tumors (ISCT) ; They are one of the most rare of central nervous system tumors. ISCT have an incidence of 2-10/100.000 among the population and they are mostly characterized as benign. Primary choice of treatment in ISCT is surgical. The purpose of the surgical treatment is the removal of tumor tissue without causing any possible damage to the surrounding neural tissue. Intraoperative (Neurophysiological Monitoring) Neuromonitarization (IONM), encompasses all the techniques that are responsible for assessing the condition of spine and peripheral neurons during surgery. During our retroactive and definitive study, we have inspected patients that have been diagnosed with Intradural Spinal Cord Tumor whom have been treated at Ege University's Medical Faculty, Neurosurgery Division, between October 2011 – February 2016, on the basis of socio-demographic properties (age, sex, … etc.), mass location, pathology results, pre-op and post-op neurological condition, total or partial resection of the tumor, and the usage of intraoperative neuromonitorization. Among the 38 subjects included in the study, the female participants composed 63.2% of the total. The minimum age was 18 years and the maximum was 79 years with the average being 46.0 ± 15.5 years. 22 of the subjects (%57.9) were treated with IONM while 16 of them (% 42.1) were not treated with IONM. The highest percentage of location (%39.5) belonged to Thoracic Vertebrae within the cases. 20 of the 38 subjects were diagnosed with pre-op neurological deficit and 4 patients had a deteriorating post-op neurological deficit with 31 patients (%81.6) having no change in their condition. 29 cases had total tumor resection. 9 cases had partial tumor resection. In this study, which we have used 38 participants ,using statistical methods, we have concluded that there is no significant relationship between the inspected variables and IONM usage, however, an experienced surgical team with optimal technical equipment provided, an IONM evaluated by an experienced team could provide positive effect on the outcome. For more concrete results, well planned prospective studies are necessary. Nevertheless due to ethical reasons and medicolegal constrictions, it is controversial to conduct randomized controlled tests to evaluate the positive effects of IONM usage on surgical results.