Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2012
[Application of intraoperative neurophysiological monitoring in spinal cord surgery].
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Lin Guo-zhong, Wang Zhen-yu, Liu Bin
Аннотация
OBJECTIVE: To study application of intraoperative neurophysiological monitoring(IONM) in spinal cord surgery.
METHODS: In the study, 24 patients with spinal cord tumors were divided into 4 groups according to the method of monitoring. Group A (ventral tumors) underwent somatosensory evoked potential (SEP) + motor evoked potential (MEP) + electromyography (EMG) monitoring, group B (intramedullary tumors) underwent SEP + MEP monitoring, group C (subdural extramedullary tumors) underwent SEP + EMG monitoring, group D (conus medullary and cauda equina lesions) underwent EMG monitoring. The relationship between changes of IONM and postoperative neurological function was analyzed.
RESULTS: All of the 3 patients in group A had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case. All of the 6 patients in group B had IONM alteration, of whom 5 recovered before the end of surgery, and 1 did not recover and neurological function deteriorated in this case. Seven of the nine patients in group C had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case. All of the 6 patients in group D had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case.
CONCLUSION: IONM is useful to reduce postoperative neurological deterioration. However, IONM neurophysiological monitoring needs further improvement.
METHODS: In the study, 24 patients with spinal cord tumors were divided into 4 groups according to the method of monitoring. Group A (ventral tumors) underwent somatosensory evoked potential (SEP) + motor evoked potential (MEP) + electromyography (EMG) monitoring, group B (intramedullary tumors) underwent SEP + MEP monitoring, group C (subdural extramedullary tumors) underwent SEP + EMG monitoring, group D (conus medullary and cauda equina lesions) underwent EMG monitoring. The relationship between changes of IONM and postoperative neurological function was analyzed.
RESULTS: All of the 3 patients in group A had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case. All of the 6 patients in group B had IONM alteration, of whom 5 recovered before the end of surgery, and 1 did not recover and neurological function deteriorated in this case. Seven of the nine patients in group C had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case. All of the 6 patients in group D had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case.
CONCLUSION: IONM is useful to reduce postoperative neurological deterioration. However, IONM neurophysiological monitoring needs further improvement.