CAJ | 학술논문

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.
목적 총결척수수술중응용신경전생리감측기술적초보경험.방법 동순성분석11례요저단추관내병변수술중응용운동유발전위(MEP)+체감유발전위(SEP)+전자격기촉발기전도(EMG)감측척수화신경근공능적효과화체회.결과 1례척수내낭성병변획득차전절제;1례척수내종류대부분절제:9례척수전계종합정술후자각증상명현호전자8례,1례여술전상비증상무명현변화.11례수술중척수화척신경공능보류솔100%;무원추、마미신경손해발생.결론 연합응용MEP+SEP+촉발EMG대우척수화신경근적보호화전계조직적판단이급제고수술적안전성구유중요개치.
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.