脊柱手术中皮层体感诱发电位基准的选择

目的通过对脊柱手术术中皮层体感诱发电位（cortical somatosensory evoked potential,CSEP）监护波形分析,了解其变化规律,制定合理的基准和报警标准,降低监护过程中脊髓损伤预报的假阳性事件,提高脊髓监护的可靠性。方法回顾性分析76例不同类型的脊柱手术术中脊髓监护,将监护期分为预测试期、调整期、重点监护期、报警期,对应基准分别为I期、Ⅱ期、Ⅲ期、Ⅳ期基准,分析诸期的基准特点,由此决定报警标准。按有无神经功能缺陷将76例患者分为A、B两组,对比两组脊髓监护的假阳性率;结果四期基准报警率之间有显著性差异,Ⅳ期基准的报警符合率最高。A与B两组的假阳性率之间有显著性差异,A组假阳性率高于B组;结论术前有神经缺陷较无神经缺陷的脊柱疾患,CSEP假阳性率高,应尽量采用联合监护;报警标准和基准要因时而异、综合分析,不可教条化。

Intraoperative spinal cord monitoring during spinal surgery with cortical somatosensory evoked potentials

Objective: To diminish the false-positive rates and improve the reliability of monitoring,the characteristic of the cortical somatosensory evoked potentials(CSEP) for intraoperative spinal cord monitoring during spinal surgery.Methods: Seventy-SIX patients undergoing intraoperative spinal cord monitoring were collected in this retrospective study.Two distinct groups(A and B groups) of patients were identified from analyzing neurological function preoperatively and the false-positive rates were recorded post...