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1.

001-es BibID:BIBFORM034524
Első szerző:Eggspuehler, Andreas
Cím:Multimodal intraoperative monitoring (MIOM) during cervical spine surgical procedures in 246 patients / Eggspuehler Andreas, Sutter Martin A., Grob Dieter, Jeszenszky Dezsö, Porchet Francois, Dvorak Jiri
Dátum:2007
ISSN:0940-6719
Megjegyzések:A prospective study of 246 patients who received multimodal intraoperative monitoring during cervical spine surgery between March 2000 and December 2005. To determine the sensitivity and specificity of MIOM techniques used to monitor spinal cord and nerve root function during cervical spine surgery. It is appreciated that complication rate of cervical spine surgery is low, however, there is a significant risk of neurological injury. The combination of monitoring of ascending and descending pathways may provide more sensitive and specific results giving immediate feedback information and/or alert regarding any neurological changes during the operation to the surgeon. Intraoperative somatosensory spinal and cerebral evoked potentials combined with continuous EMG and motor-evoked potentials of the spinal cord and muscles were evaluated and compared with postoperative clinical neurological changes. A total of 246 consecutive patients with cervical pathologies, majority spinal stenosis due to degenerative changes of cervical spine were monitored by means of MIOM during the surgical procedure. About 232 patients presented true negative while 2 patients false negative responses. About ten patients presented true positive responses where neurological deficit after the operation was predicted and two patients presented false positive findings. The sensitivity of MIOM applied during cervical spine procedure (anterior and/or posterior) was 83.3% and specificity of 99.2%. MIOM is an effective method of monitoring the spinal cord functional integrity during cervical spine surgery and can help to reduce the risk of neurological deficit by alerting the surgeon when monitoring changes are observed.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 16 : S2 (2007), p. 209-215. -
További szerzők:Sutter, Martin A. Grob, Dieter Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Porchet, Françis Dvorak, Jiri
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2.

001-es BibID:BIBFORM034523
Első szerző:Eggspuehler, Andreas
Cím:Multimodal intraoperative monitoring during surgery of spinal deformities in 217 patients / Eggspuehler Andreas, Sutter Martin A., Grob Dieter, Jeszenszky Dezsö, Dvorak Jiri
Dátum:2007
ISSN:0940-6719
Megjegyzések:A prospective study was performed on 217 patients who received MIOM during corrective surgery of spinal deformities between March 2000 and December 2005. Aim is to determine the sensitivity and specificity of MIOM techniques used to monitor spinal cord and nerve root function during corrective spine surgery. MIOM is becoming an increasingly used method of monitoring function during corrective spine surgery. The combination of monitoring of ascending and descending pathways may provide more sensitive and specific results giving immediate feedback information regarding any neurological deficits during the operation. Intraoperative somatosensory spinal and cerebral evoked potentials combined with continuous EMG and motor evoked potentials of the spinal cord and muscles were evaluated and compared with postoperative clinical neurological changes. A total of 217 consecutive patients with spinal deformities of different aetiologies were monitored by means of MIOM during the surgical procedure. Out of which 201 patients presented true negative findings while one patient presented false negative and three patients presented false positive findings. Twelve patients presented true positive findings where neurological deficit after the operation was predicted. All neurological deficits in those 12 patients recovered completely. The sensitivity of MIOM applied during surgery of spinal deformities has been calculated of 92.3% and the specificity 98.5%. Based upon the results of this study MIOM is an effective method of monitoring the spinal cord and nerve root function during corrective surgery of spinal deformities and consequently improves postoperative results. The Wake-up test for surgical procedure of spinal deformities became obsolete in our institution.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 16 : S2 (2007), p. 188-196. -
További szerzők:Sutter, Martin A. Grob, Dieter Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Dvorak, Jiri
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3.

001-es BibID:BIBFORM034466
Első szerző:Eggspuehler, Andreas
Cím:Multimodal intraoperative monitoring (MIOM) during surgical decompression of thoracic spinal stenosis in 36 patients / Eggspuehler Andreas, Sutter Martin A., Grob Dieter, Porchet F., Jeszenszky Dezsö, Dvorak Jiri
Dátum:2007
ISSN:0940-6719
Megjegyzések:A prospective study of 36 patients who received multimodal intraoperative monitoring (MIOM) during decompression of thoracic spinal stenosis between March 2000 and December 2005 was chosen as the study design. The objective was to determine the sensitivity and specificity of MIOM techniques used for monitoring spinal cord during surgical thoracic decompression. The background data revealed that the surgical decompression for thoracic spinal stenosis is less frequent than in other regions of the spine. However, due to the relative narrow spinal canal, neurological complications could be severe. The combination of monitoring ascending and descending pathways may provide an early alert to the surgeon in order to alter the surgical procedure, and avoid neurological complications. The methods involved evaluation of intraoperative somatosensory spinal and cerebral evoked potentials and motor evoked potentials of the spinal cord and muscles that were compared with post operative clinical neurological changes. 36 consecutive patients with thoracic spinal stenosis of different aetiologies were monitored by the means of MIOM during the surgical procedure. 31 patients had true negative while one patient had false positive findings. Three patients had true positive and one patient had false negative findings. This indicates a sensitivity of 75% and a specificity of 97%. The one case of false negative findings recovered completely within 3 months. In conclusion, the MIOM is an effective method of monitoring the spinal cord during surgical decompression of the thoracic spine.
Tárgyszavak:Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 16 : S2 (2007), p. 216-220. -
További szerzők:Sutter, Martin A. Grob, Dieter Porchet, Françis Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Dvorak, Jiri
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4.

001-es BibID:BIBFORM034533
Első szerző:Mannion, Anne F.
Cím:The quality of spine surgery from the patient's perspective : part 2. Minimal clinically important difference for improvement and deterioration as measured with the Core Outcome Measures Index / Mannion A. F., Porchet F., Kleinstück F. S., Lattig F., Jeszenszky D., Bartanusz V., Dvorak J., Grob D.
Dátum:2009
ISSN:0940-6719
Megjegyzések:The Core Outcome Measures Index (COMI) is a reliable and valid instrument for assessing multidimensional outcome in spine surgery. The minimal clinically important score-difference (MCID) for improvement (MCID(imp)) was determined in one of the original research studies validating the instrument, but has never been confirmed in routine clinical practice. Further, the MCID for deterioration (MCID(det)) has never been investigated; indeed, this needs very large sample sizes to obtain sufficient cases with worsening. This study examined the MCIDs of the COMI in routine clinical practice. All patients undergoing surgery in our Spine Center since February 2004 were asked to complete the COMI before and 12 months after surgery. The COMI has one question each on back (neck) pain intensity, leg/buttock (arm/shoulder) pain intensity, function, symptom-specific well-being, general quality of life, work disability, and social disability, scored as a 0-10 index. At follow-up, patients also rated the global effectiveness of surgery, on a 5-point Likert scale. This was used as the external criterion ("anchor") in receiver operating characteristics (ROC) analyses to derive cut-off scores for individual improvement and deterioration. Twelve-month follow-up questionnaires were returned by 3,056 (92%) patients. The group mean COMI score change for patients declaring that the "operation helped" was a reduction of 3.1 points; the corresponding value for those whom it "did not help" was a reduction of 0.5 points. The group MCID(imp) was hence 2.6 points reduction; the corresponding group MCID(det) was 1.2 points increase (0.5 minus -0.7). The area under the ROC curve was 0.88 for MCID(imp) and 0.89 for MCID(det) (both P < 0.0001), indicating that the COMI had good discriminative ability. The cut-offs for individual improvement and deterioration, respectively, were > or =2.2 points decrease (sensitivity 81%, specificity 83%) and > or =0.3 points increase (sensitivity 83%, specificity 88%). The MCID(imp) score of 2.2 points was similar to that reported in the original study (2-3 points, depending on external criterion used). The MCID(det) suggested that the COMI is less responsive to deterioration than to improvement, a phenomenon also reported for other spine outcome instruments. This needs further investigation in even larger patient groups. The MCIDs provide essential information for both the planning (sample size) and interpretation of the results (clinical relevance) of future clinical studies using the COMI.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 18 : S3 (2009), p. 374-379. -
További szerzők:Porchet, Françis Kleinstück, Frank S. Lattig, Friederike Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Bartanusz, Viktor Dvorak, Jiri Grob, Dieter
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5.

001-es BibID:BIBFORM034532
Első szerző:Mannion, Anne F.
Cím:The quality of spine surgery from the patient's perspective : part 1: The Core Outcome Measures Index in clinical practice / Mannion Anne F., Porchet F., Kleinstück F. S., Lattig F., Jeszenszky D., Bartanusz V., Dvorak J., Grob D.
Dátum:2009
ISSN:0940-6719
Megjegyzések:The Core Outcome Measures Index (COMI) is a short, multidimensional outcome instrument, with excellent psychometric properties, that has been recommended for use in monitoring the outcome of spinal surgery from the patient's perspective. This study examined the feasibility of implementation of COMI and its performance in clinical practice within a large Spine Centre. Beginning in March 2004, all patients undergoing spine surgery in our Spine Centre (1,000-1,200 patients/year) were asked to complete the COMI before and 3, 12 and 24 months after surgery. The COMI has one question each on back (neck) pain intensity, leg/buttock (arm/shoulder) pain intensity, function, symptom-specific well being, general quality of life, work disability and social disability, scored as a 0-10 index. At follow-up, patients also rated the global effectiveness of surgery, and their satisfaction with their treatment in the hospital, on a five-point Likert scale. After some fine-tuning of the method of administration, completion rates for the pre-op COMI improved from 78% in the first year of operation to 92% in subsequent years (non-response was mainly due to emergencies or language or age issues). Effective completion rates at 3, 12 and 24-month follow-up were 94, 92 and 88%, respectively. The 12-month global outcomes (from N = 3,056 patients) were operation helped a lot, 1,417 (46.4%); helped, 860 (28.1%); helped only little, 454 (14.9%); did not help, 272 (8.9%); made things worse, 53 (1.7%). The mean reductions in COMI score for each of these categories were 5.4 (SD2.5); 3.1 (SD2.2); 1.3 (SD1.7); 0.5 (SD2.2) and -0.7 (SD2.2), respectively, yielding respective standardised response mean values ("effect sizes") for each outcome category of 2.2, 1.4, 0.8, 0.2 and 0.3, respectively. The questionnaire was feasible to implement on a prospective basis in routine practice, and was as responsive as many longer spine outcome questionnaires. The shortness of the COMI and its multidimensional nature make it an attractive option to comprehensively assess all patients within a given Spine Centre and hence avoid selection bias in reporting outcomes.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 18 : S3 (2009), p. 367-373. -
További szerzők:Porchet, Françis Kleinstück, Frank S. Lattig, Friederike Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Bartanusz, Viktor Dvorak, Jiri Grob, Dieter
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6.

001-es BibID:BIBFORM077981
Első szerző:Sutter, Martin A.
Cím:The impact and value of uni- and multimodal intraoperative neurophysiological monitoring (IONM) on neurological complications during spine surgery : a prospective study of 2728 patients / Martin Sutter, Andreas Eggspuehler, Dezso Jeszenszky, Frank Kleinstueck, Tamás F. Fekete, Daniel Haschtmann, François Porchet, Jiri Dvorak
Dátum:2019
ISSN:0940-6719
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 28 : 3 (2019), p. 599-610. -
További szerzők:Eggspuehler, Andreas Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Kleinstück, Frank S. Fekete Tamás Fülöp Haschtmann, Daniel Porchet, Françis Dvorak, Jiri
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7.

001-es BibID:BIBFORM034528
Első szerző:Sutter, Martin A.
Cím:The validity of multimodal intraoperative monitoring (MIOM) in surgery of 109 spine and spinal cord tumors / Sutter Martin, Eggspuehler Andreas, Grob Dieter, Jeszenszky Dezsö, Benini Arnaldo, Porchet Francois, Mueller Alfred, Dvorak Jiri
Dátum:2007
ISSN:0940-6719
Megjegyzések:In a prospective study of 109 patients with tumor of the spine MIOM was performed during the surgical procedure between March 2000 and December 2005. To determine the sensitivity and specificity of MIOM techniques used to monitor spinal cord and nerve root function during surgical procedure of spinal tumors. MIOM become an integrated procedure during surgical approach to intramedullar and extramedullar spine tumors. The combination of monitoring ascending and descending pathways may provide more sensitive and specific results than SEP alone giving immediate feedback information regarding any neurological deficit during the operation. Intraoperative sensory spinal and cerebral evoked potential combined with EMG recordings and motor evoked potential of the spinal cord and muscles were evaluated and compared with postoperative clinical neurological changes. One hundred and nine consecutive patients with spinal tumors of different aetiologies were monitored by the means of MIOM during the entire surgical procedure. Eighty-two patients presented true negative findings while two patients monitored false negative, one false positive and 24 patients true positive findings where neurological deficits after the operation were present. All patients with neurological deficit recovered completely or to pre-existing neurological situation. The sensitivity of MIOM applied during surgery of spinal tumors has been calculated of 92% and specificity 99%. Based upon the results of the study MIOM is an effective method of monitoring the spinal cord and nerve root function during surgical approach of spinal tumors and consequently can reduce or prevent the occurrence of postoperative neurological deficit.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 16 : S2 (2007), p. 197-208. -
További szerzők:Eggspuehler, Andreas Grob, Dieter Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Benini, Arnaldo Porchet, Françis Mueller, Alfred Dvorak, Jiri
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8.

001-es BibID:BIBFORM034527
Első szerző:Sutter, Martin A.
Cím:The diagnostic value of multimodal intraoperative monitoring (MIOM) during spine surgery : a prospective study of 1,017 patients / Sutter Martin, Eggspuehler Andreas, Grob Dieter, Jeszenszky Dezsoe, Benini Arnaldo, Porchet Francois, Mueller Alfred, Dvorak Jiri
Dátum:2007
ISSN:0940-6719
Megjegyzések:A prospective study of 1,017 patients who received MIOM during spine surgery procedures between March 2000 and December 2005. To determine the sensitivity and specificity of MIOM techniques used to monitor spinal cord and nerve roots function during spine surgery. MIOM has become a widely used method of monitoring neural function during spine surgery. Several techniques only monitor either ascending or descending pathways and thus may not provide sensitive or specific results. MIOM aims to monitor both ascending and descending pathways therefore giving immediate feedback information regarding any neurological deficits during the operation. Intraoperative sensory spinal and cortical evoked potentials, combined with monitoring of EMG and motor evoked potentials recorded from the spinal cord and muscles elicited by electrical motor cortex, spinal cord, cauda equina and nerve root stimulation, was evaluated and compared with post-operative clinical neurological changes. One thousand and seventeen consecutive patients underwent a total of 4,731 h of MIOM to evaluate any neural deficits that may have occurred during spine surgery. Of these, 935 were true negative cases, 8 were false negative cases, 66 were true positive cases and 8 were false positive cases, resulting in a sensitivity of 89% and a specificity of 99%. Based on the results of this study, MIOM is an effective method of monitoring the spinal cord functional integrity during spine surgery and therefore can lead to reduction of neurological deficit and consequently improve postoperative results.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 16 : S2 (2007), p. 162-170. -
További szerzők:Eggspuehler, Andreas Grob, Dieter Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Benini, Arnaldo Porchet, Françis Mueller, Alfred Dvorak, Jiri
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9.

001-es BibID:BIBFORM034526
Első szerző:Sutter, Martin A.
Cím:Multimodal intraoperative monitoring (MIOM) during 409 lumbosacral surgical procedures in 409 patients / Sutter Martin A., Eggspuehler Andreas, Grob Dieter, Porchet Francois, Jeszenszky Dezsö, Dvorak Jiri
Dátum:2007
ISSN:0940-6719
Megjegyzések:A prospective study on 409 patients who received multimodel intraoperative monitoring (MIOM) during lumbosacral surgical procedures between March 2000 and December 2005 was carried out. The objective of this study was to determine the sensitivity and specificity of MIOM techniques used to monitor conus medullaris, cauda equina and nerve root function during lumbosacral decompression surgery. MIOM has increasingly become important to monitor ascending and descending pathways, giving immediate feedback information regarding any neurological deficit during the decompression and stabilisation procedure in the lumbosacral region. Intraoperative spinal- and cortical-evoked potentials, combined with continuous EMG- and motor-evoked potentials of the muscles, were evaluated and compared with postoperative clinical neurological changes. A total of 409 consecutive patients with lumbosacral spinal stenosis with or without instability were monitored by MIOM during the entire surgical procedure. A total of 388 patients presented true-negative findings while two patients presented false negative and 1 patient false-positive findings. Eighteen patients presented true-positive findings where neurological deficit after the operation was intraoperatively predicted. Of the 18 true-positive findings, 12 patients recovered completely; however, 6 patients recovered only partially. The sensitivity of MIOM applied during decompression and fusion surgery of the lumbosacral region was calculated as 90%, and the specificity was calculated as 99.7%. On the basis of the results of this study, MIOM is an effective method of monitoring the conus medullaris, cauda equina and nerve root function during surgery at the lumbosacral junctions and might reduce postoperative surgical-related complications and therefore improve the long-term results.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:European Spine Journal. - 16 : S2 (2007), p. 221-228. -
További szerzők:Eggspuehler, Andreas Grob, Dieter Porchet, Françis Jeszenszky Dezső (1954-) (idegsebész, ortopédus) Dvorak, Jiri
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