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首页> 美国卫生研究院文献>European Spine Journal >Intraoperative control by somatosensory evoked potentials in the treatment of cervical myeloradiculopathy. Results in 210 cases
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Intraoperative control by somatosensory evoked potentials in the treatment of cervical myeloradiculopathy. Results in 210 cases

机译：体感诱发电位的术中控制在治疗颈椎脊髓神经病中。结果210例

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摘要

Somatosensory evoked potentials (SEPs) were used for continuous monitoring of 210 patients during anterior surgery for cervical myeloradiculopathy, to test how effectively they help avoid irreversible neurological damage during surgery. The pathologies differed in severity and were treated by diskectomy or by extended corporectomy using the Senegas technique. Intraoperative SEP changes were recorded in 84 patients (40%); in 13 (6.2%) of these, changes in SEP amplitude and latency were caused by mechanical stress. SEPs revealed transient episodes of regional ischaemia or neurophysiological anomalies during anaesthesia (mainly hypotension) in 27 patients (12.8%). The traces detected incipient and potentially dangerous mechanical pressure on, or metabolic anomalies of, the spinal cord during manipulation and placement procedures of spinal fixation devices. They were particularly sensitive indicators of ischaemia; one of the most common causes of irreversible injury. The traces of 44 patients (21.0%) improved markedly during surgery. There were no false-negatives in this series and, thanks to the fact that SEPs gave immediate warnings of incipient ischaemia to the surgical team, we had no case of irreversible medullary or nerve-root deficit.
机译：体感诱发电位（SEPs）用于对颈椎脊髓神经病的前期手术期间的210名患者进行连续监测，以测试其在避免手术过程中不可逆转的神经系统损害方面的有效性。病理的严重程度不同，使用Senegas技术通过椎间盘切除术或扩大的肾切除术治疗。记录了84例患者（40％）的术中SEP改变；在其中的13个（6.2％）中，SEP振幅和潜伏期的变化是由机械应力引起的。 SEPs在27例患者中（主要是低血压）在麻醉期间显示局部缺血或神经生理异常的短暂发作（12.8％）。在脊柱固定装置的操作和放置过程中，该痕迹检测到对脊髓的初期和潜在危险的机械压力或代谢异常。它们是缺血性特别敏感的指标；不可逆损伤的最常见原因之一。手术期间44例患者的痕迹（21.0％）明显改善。在该系列中没有假阴性，而且由于SEP立即向外科手术团队发出了局部缺血的预警，因此我们没有发生不可逆的延髓或神经根缺损的情况。

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