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Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.117
vdae090.117
Final Category: Spinal Cord Metastases
AcademicSubjects/MED00300
AcademicSubjects/MED00310
SPCM-03 TRENDS IN INTRAOPERATIVE NEUROMONITORING USAGE IN SURGERIES FOR PATIENTS WITH DIAGNOSED PRIMARY MALIGNANT SPINE TUMORS
Bishop Brandon Duke University, Durham/NC, USA

Woo Joshua Duke University, Durham/NC, USA

Rowe Dana Duke University, Durham/NC, USA

Luo Emily Duke University, Durham/NC, USA

Ndika Tobechukwu Duke University, Durham/NC, USA

Charles Antoinette Duke University, Durham/NC, USA

Arango Alissa Duke University, Durham/NC, USA

Yoo Seeley Duke University, Durham/NC, USA

Zachem Tanner Duke University, Durham/NC, USA

O’Callaghan Ellen Duke University, Durham/NC, USA

Owolo Edwin Duke University, Durham/NC, USA

Sperber Jacob Duke University, Durham/NC, USA

Crowell Kerri-Anne Duke University, Durham/NC, USA

Rivera Nicole Duke University, Durham/NC, USA

Nguyen Annee Duke University, Durham/NC, USA

Hockenberry Harrison Duke University, Durham/NC, USA

Reitz Kendall Duke University, Durham/NC, USA

Dalton Tara Duke University, Durham/NC, USA

Johnson Eli Duke University, Durham/NC, USA

Erickson Melissa Duke University, Durham/NC, USA

Goodwin C Rory Duke University, Durham/NC, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i35i35
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

BACKGROUND

Given the complex nature of surgical resection and the potential for neural injury in spinal tumor surgery, the use of intraoperative neuromonitoring (IONM) could improve clinical outcomes and injury prevention in surgeries for patients diagnosed with primary malignant spine tumors (PMTs). While IONM has been growing in usage, especially during spinal procedures, its utility has been mixed due to undefined guidelines and potentially high costs. In this study, we examined trends in IONM use in surgeries for PMT patients, regional variations in IONM usage, and associations between IONM and clinical outcomes.

METHODS

A retrospective review was performed using the PearlDiver Patient Record Database to identify cases of PMTs that underwent surgery from 2011 to 2021. Rates of IONM usage were compared based on patient age, sex, family income, and region. Complications and 30-day readmissions were also assessed.

RESULTS

4,551 patients undergoing surgery for PMTs were identified, with 1,643 (36.1%) of these utilizing IONM. Significant regional variability was observed in IONM usage (Midwest: 32.6%; Northeast: 28.1%; South: 26.4%; West: 12.5%; p < 0.001) and those using IONM were more likely to be in inpatient settings, compared to outpatient (p < 0.001). Both younger age and mean family income were associated with IONM usage (p < 0.001, p < 0.01, respectively), although, clinically insignificant. 30-day readmission rates and complication rates were significantly higher for patients undergoing PMT surgery with IONM (both p < 0.001).

CONCLUSIONS

This study demonstrates significant differences in IONM usage across geographic regions, sex, and operation settings among PMT patient surgeries. Differences in family income were observed to be significant but not clinically relevant. Notably, IONM was associated with higher 30-day post-operative readmission rates and complication rates. Given the increased adoption of IONM, these trends provide valuable insights in assessing its value and applicability across diverse settings.
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pmc
