神经电生理监测技术在脊髓手术中应用11例报告

目的 总结脊髓手术中应用神经电生理监测技术的初步经验.方法 同顺性分析11例腰骶段椎管内病变手术中应用运动诱发电位(MEP)+体感诱发电位(SEP)+电刺激器触发肌电图(EMG)监测脊髓和神经根功能的效果和体会.结果 1例脊髓内囊性病变获得次全切除;1例脊髓内肿瘤大部分切除:9例脊髓拴系综合征术后自觉症状明显好转者8例,1例与术前相比症状无明显变化.11例手术中脊髓和脊神经功能保留率100%;无圆锥、马尾神经损害发生.结论 联合应用MEP+SEP+触发EMG对于脊髓和神经根的保护和拴系组织的判断以及提高手术的安全性具有重要价值.

Application of intraoperative neural electrophysiological monitoring during spinal cord surgery:report of 11 cases

Objective To summarize our experience with intraoperative neural electrophysiological monitoring during spinal cord surgery. Methods The clinical data of 11 patients undergoing spinal cord surgery with intraoperative neural electrophysioiogical monitoring were retrospectively reviewed, and the monitoring was performed by recording the motor-evoked potential (MEP), somatosensory evoked potential (SEP), and evoked electromyography (EMG). Results Subtotal resection of the intramedullary cystic lesion was performed in 1 case and partial resection of the intramedullary tumor in another. In 9 cases of tethered spinal cord syndrome, obvious improvement was obtained in 8 cases, and the other 1 case showed no obvious changes in the symptoms after the operation. In all the 11 cases, the spinal cord remained intact and its function was totally preserved without damage of the eonus medullaris or the cauda equine. Conclusion Combined monitoring of MEP, SEP, and evoked EMG during spinal cord surgery is useful for protecting the spinal cord and the nerves roots, and may enhance the detection of the tethered tissue and ensure better safety of operations.