摘要
目的分析联合应用体感诱发电位(somatosensory evoked potential,SSEP)、经颅刺激运动诱发电位(transcranial motor evoked potential,Tc-MEP)和自发肌电图(spontaneous electromyography,sEMG)在脊髓型颈椎病术中对医源性神经损害的预测作用。方法对30例脊髓型颈椎病患者行术中联合监测。SSEP监测双侧正中神经或尺神经和胫神经,Tc-MEP记录双侧鱼际肌和展肌,sEMG监测手术节段神经所支配肌肉。根据术中监测结果与术后功能相比较并行统计学分析。结果SSEP、Tc-MEP、sEMG单独监测与联合监测的成功检出率分别为100%,86.7%,100%和100%;术中SSEP监护达报警标准4例;Tc-MEP消失3例;术中出现sEMG报警5例。联合检测的灵敏度和特异性均100%。结论多模式联合监测技术是颈椎手术中理想的监测方法。
Objective To determine the role of combined multi-mode nerve monitoring of somatosensory evoked potential（SSEP） ,tran- scranial motor evoked potential（Tc-MEP） and spontaneous electromyography（sEMG） in the surgery of cervical spondylosis myelopathy. Methods Combined intraoperative monitoring was performed in 30 patients undergoing cervical spondylosis myelopathy surgeries. SSEP was used to observe the bilateral median nerves, ulnar nerves and tibial nerves. Tc-MEP was used to record bilateral thenar mus- cles and hallucis abductor muscles. The sEMG was used to monitor the muscles dominated by surgical spinal segments. The relationship between intraoperative monitoring results and postoperative functions was analyzed. Results The success detection rate of spinal cord injury by SSEP,Tc-MEP, sEMG and combined monitoring was 100%, 86.7%, 100% and 100%, respectively. Four cases reached alarm standard of SSEP, 3 patients showed Tc-MEP disappearing, and 5 cases of sEMG alarm during surgeries. The sensitivity and speficity were both 100% by combined monitoring. Conclusion Multi-mode intraoperative nerve monitoring during cervical spine surgery is an ideal method.
出处
《山西医科大学学报》
CAS
2015年第2期181-184,共4页
Journal of Shanxi Medical University
关键词
体感诱发电位
经颅刺激运动诱发电位
自发肌电图
联合监测
脊髓型颈椎病
somatosensory evoked potential
transcranial motor evoked potential
spontaneous electromyography
combinedmonitoring
cervical spondylosis myelopathy
