Haoyuan Wang,1,2,* Zhao Chen,1,* Xianxiang Wang,1 Yiquan Zhang,1 Hui Wang,1 Ke Zhang1 

1Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, People’s Republic of China; 2Department of Neurosurgery, Yuexi Hospital of the First Affiliated Hospital of Anhui Medical University, Anqing, Anhui, 246600, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ke Zhang, Email zhangke@ahmu.edu.cn; Haoyuan Wang, Email wanghaoyuan@ahmu.edu.cn

Objective: To explore the clinical application value of neurophysiological monitoring combined with ultrasound guidance in Acute spinal cord injury.
Methods: Ten patients with acute spinal cord injury underwent intramedullary decompression surgery under neurophysiological monitoring and intraoperative ultrasound guidance. ASIA (American Spinal Injury Association) classification and JOA (Japan Orthopaedic Association) scoring were performed preoperatively and postoperatively.
Results: The preoperative, 1-week postoperative, and 1-year postoperative JOA scores for the ten patients were (6.2 ± 1.55), (7 ± 1.58), and (11.8 ± 1.60), respectively. The JOA improvement rates at 1 week and 1 year postoperation were 7.4% and 51.9%, respectively. Among the patients, one patient had severe thoracic spinal cord injury upon admission, and their ASIA classification remained at Grade A after 1 year postoperation, while the remaining nine patients showed varying degrees of neurological function improvement.
Conclusion: Intraoperative neurophysiological monitoring combined with intraoperative ultrasound not only allows for timely monitoring of spinal cord function but also enables observation of whether decompression is adequate during surgery. It represents a very good surgical option for patients with spinal cord injuries.

Keywords: acute spinal cord injury, neurophysiological monitoring, intraoperative ultrasound, intramedullary decompression surgery