New Research Links Intraoperative Monitoring to Faster Recovery, Reduced Pain After Spine Surgery
A new study published in Spine demonstrates that utilizing motor-evoked potential (MEP) monitoring during spine surgery is associated with a statistically significant reduction in both hospital length of stay and postoperative acute pain. the findings, released today, offer compelling evidence for wider adoption of this neurophysiological monitoring technique, potentially improving outcomes for the hundreds of thousands of patients undergoing spinal procedures annually.
Spine surgery, while frequently enough necessary to alleviate debilitating pain and neurological deficits, carries inherent risks, including potential for spinal cord injury. MEP monitoring-which assesses the functionality of neural pathways during surgery by measuring the brain’s response to electrical stimulation of the spinal cord-allows surgeons to detect and mitigate these risks in real-time. This latest research quantifies the benefits beyond safety, showing a tangible impact on recovery time and patient comfort. The study analyzed data from over 2,000 patients undergoing various spine surgeries between 2017 and 2023.
Researchers, led by Dr. Richard A. Deyo at the University of Washington, retrospectively reviewed data from patients who underwent spine surgery with and without MEP monitoring. results indicated that patients undergoing surgery with MEP monitoring experienced, on average, a 0.7-day shorter hospital stay (p < 0.001) and reported lower pain scores on postoperative days one and two (p < 0.01).Specifically, the average hospital stay for patients without MEP monitoring was 3.2 days, compared to 2.5 days for those with monitoring. Pain scores,measured on a 0-10 scale,were approximately 1.2 points lower in the MEP monitoring group during the initial postoperative period.
“These findings suggest that MEP monitoring isn’t just about preventing catastrophic neurological events; it’s also about optimizing the overall surgical experience and facilitating a quicker return to normal life for patients,” explained Dr. Deyo. “Reducing hospital stay not only improves patient satisfaction but also lowers healthcare costs.”
The study included a diverse range of spinal procedures, including laminectomies, fusions, and discectomies.While the benefits were consistent across procedure types,the researchers noted a more pronounced effect in complex revision surgeries. The analysis controlled for potential confounding factors such as patient age, body mass index, pre-existing medical conditions, and surgical complexity.
Despite the promising results, the authors acknowledge limitations, including the retrospective nature of the study and the potential for selection bias-surgeons may preferentially use MEP monitoring in more complex cases or on patients deemed higher risk. Further prospective, randomized controlled trials are needed to definitively establish a causal relationship and to determine the optimal protocols for MEP monitoring in different surgical scenarios. Though, the current data provides strong support for considering MEP monitoring as a standard of care in spine surgery, notably as healthcare systems increasingly focus on value-based care and patient-centered outcomes.
