Response to the Letter to the Editor: Evaluation of the Association between Neck Pain and the Trapezius Muscles in Patients with Cervical Myelopathy Using Motor Evoked Potential: A Retrospective Study
- Sadayuki Ito1, Yoshihito Sakai2, Atsushi Harada2, Kei Ando1, Kazuyoshi Kobayashi1, Hiroaki Nakashima1, Masaaki Machino1, Shunsuke Kambara1, Taro Inoue1, Tetsuro Hida3, Kenyu Ito4, Naoki Ishiguro1, Shiro Imagama1
- Received December 20, 2023 Accepted December 23, 2023
- Thank you very much for your interest in our paper [1], “Evaluation of the association between neck pain and the trapezius muscles in patients with cervical myelopathy using motor evoked potential: a retrospective study.” Thank you very much for your very valuable comments. We responded to the best of our ability at this time.1. First, we would like to appreciate the researcher for clearly and concisely describing the informative and interesting introduction part. It enhances our interest in studying more about neck pain and its association with the trapezius muscle in patients with cervical myelopathy using the motor-evoked potential, it helps us to become aware of the new information about the motor-evoked potential. The study shows that the stability of cervical vertebrae and the neck extensor muscles are important in the prevention of bending and rotation, which the reader can easily comprehend. In this scientific research, the introduction part was lacking the hypothesis of this study.Response: Our study began with the following hypotheses: In patients with cervical myelopathy, preoperative neck pain is hypothesized to be associated with abnormal trapezius muscle activity.2. Secondly, in the literature method and material section, there was no information about how to calculate the sample size for the research. In this scientific literature, the inclusion and exclusion criteria of the participants were not mentioned clearly. According to several studies, it is recommended to consider age and gender specifications when recruiting participants, as the aging process can lead to wear and tear of cervical ligaments. However, this study lacks literature discussing the area of neck pain (whether bilateral or unilateral), the stage of myelopathy, paraesthesia, and body mass index, as these factors can contribute to increased neck pain [2,3]. Furthermore, the study fails to specify exclusion criteria, and there is a lack of reference in the measurement section.Response: The analysis was performed on the cases that could be collected, and sample size calculations were not available. Cases in which spinal cord monitoring was not possible due to epilepsy or other reasons were excluded. As you indicated, age and gender were not specified in this study, since there were no significant differences between the two groups. Thank you for providing us with this valuable literature. In this case, we did not conduct a detailed interview regarding the left and right sides with regard to neck pain. The preoperative Japanese Orthopaedic Association score is tabulated below, as is the BMI, although there are no clear stage criteria (Table 1). Our report on methods is similar [4].3. Third, in the results section, there was a lack of assessment of data normality, and even duplication of data was observed [5]. Moreover, this research article did not clearly address confounding factors for latency, amplitude, and cross-sectional area.Response: As you point out, we were not able to examine those confounding factors.
- Notes
- Notes
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Conflict of Interest No potential conflict of interest relevant to this article was reported.
Author Contributions All authors provided the same amount of effort for the preparation of this commentary.
Table 1.
Neck pain (+) (VAS score ≥50) | Neck pain (-) (VAS score <50) | p-value | |
---|---|---|---|
No. of patients | 31 | 69 | |
BMI | 24.1±3.1 | 24.0±2.9 | 0.833 |
Preoperative JOA score | 10.5±3.0 | 11.9±2.4 | 0.013 |
- REFERENCES
- REFERENCES
References
1. Ito S, Sakai Y, Harada A, et al. Evaluation of the association between neck pain and the trapezius muscles in patients with cervical myelopathy using motor evoked potential: a retrospective study. Asian Spine J 2021;15:604–10.
[Article] [PubMed] [PMC]2. Ishii T, Hara T, Kusano S, Miura K, Kubo A, Kosaka J. Positive association between the cross-sectional area of the rhomboid muscle, and the range of shoulder abduction after neck dissection surgery. Phys Ther Res 2018;21:39–43.
[Article] [PubMed] [PMC]3. Kocur P, Tomczak M, Wiernicka M, Goliwas M, Lewandowski J, Lochynski D. Relationship between age, BMI, head posture and superficial neck muscle stiffness and elasticity in adult women. Sci Rep 2019;9:8515.
[Article] [PubMed] [PMC]