CAJ | 학술논문

目的：评价术中神经电生理监测在颈椎手术中的应用价值。方法对56例颈椎病患者行术中体感诱发电位（SEP）及运动诱发电位（M EP）监测，比较术前、术后SEP的变化与颈椎病临床疗效的关系，并以术前、术后JOA评分来评定临床疗效。结果术中SEP波幅上升40例，无明显变化16例。术中监测到M EP波形45例，未监测到M EP波形11例，但术后患者均恢复良好，术前、术后JOA评分差别有统计学意义。其中有1例术中SEP、M EP均正常，但术后出现一过性的四肢活动障碍，立即再次行SEP、M EP检查仍提示正常，术后四肢功能逐渐恢复正常。结论术中神经电生理监测有助于了解术中脊髓的功能状态，联合应用SEP和M EP可以有效预防和尽早检测出颈椎手术中可能存在的神经损伤。
목적：평개술중신경전생리감측재경추수술중적응용개치。방법대56례경추병환자행술중체감유발전위（SEP）급운동유발전위（M EP）감측，비교술전、술후SEP적변화여경추병림상료효적관계，병이술전、술후JOA평분래평정림상료효。결과술중SEP파폭상승40례，무명현변화16례。술중감측도M EP파형45례，미감측도M EP파형11례，단술후환자균회복량호，술전、술후JOA평분차별유통계학의의。기중유1례술중SEP、M EP균정상，단술후출현일과성적사지활동장애，립즉재차행SEP、M EP검사잉제시정상，술후사지공능축점회복정상。결론술중신경전생리감측유조우료해술중척수적공능상태，연합응용SEP화M EP가이유효예방화진조검측출경추수술중가능존재적신경손상。
Objective To determine the role of the intraoperative electrophysiological monitoring in cervical spine surgery . Methods Intraoperative somatosensory evoked potential (SEP) and motor e-voked potential (MEP) were performed in 56 patients undergoing cervical spine surgery and the results were estimated by JOA scores for the variation of the JOA scoring before and after the procedure besides the changes between intraoperative SEP ,MEP ,and clinical outcomes . Results 40 patients had SEP in-traoperative increasing ,No significant intraoperative change of SEP were found in 16 patients . A total of 45 patients had MEP signal ,No MEP signal was detected in 11 patients and these patients had good recov-ery . Generally ,postoperative JOA scores were improved significantly in the total patients . Normal in-traoperative SEP , MEP were detected in 1 case , but the limb function temporary deteriorated after surgery ,SEP and MEP were performed immediately ,and the result still be nomal ,the limb function re-turned to normal gradually . Conclusion Intraoperative electrophysiological monitoring is helpful in tes-ting the function of spinalcord . Combination use of SEP and M EP enhances the early detection of impe-ding neurological damage during cervical spine surgery .