Jiang Wenbin,Wang Junlu,Zhan Qijia,et al.Application of somatosensory evoked potential during operations of fatty filum[J].Journal of Clinical Pediatric Surgery,,21():929-935.[doi:10.3760/cma.j.cn101785-202204096-006]
Application of somatosensory evoked potential during operations of fatty filum
- Keywords:
- Cauda Equina; Pathology; Neurosurgical Procedures; Neurophysiological Monitoring; Somatosensory Evoked Potential; Child
- Abstract:
- Objective To explore the value of somatosensory evoked potential (SSEP) during operations in children with fatty filum (FT).Methods From January 2016 to December 2021,clinical data were retrospectively reviewed for 48 FT children operated at Shanghai Children’s Hospital.There were 29 boys and 19 girls with an age range from 2 months to 12 years old.The major symptoms included lower urinary tract/bladder symptoms (n=25),low back pain (n=3) and other cases were screened because of dermal sinus,anal/urinary system malformations & low conus (detected by obstetric ultrasound,n=20).The values of P37-N45 amplitude before and after surgery were compared and the correlations between age/radiological features and SSEP parameters examined.Results Among 25 children with an onset of urinary/bowel dysfunctions,24 patients had improved symptoms and 1 case showed no change during the last follow-up.The symptoms of 3 children with preoperative low back pain relieved postoperatively.The median amplitude of P37-N45 was lower in 25 children with low conus position (0.3 μV vs.0.7 μV at left side with P<0.01,0.5 μVvs.0.8 μV at right side with P<0.05).Among all cases,the median amplitude of P37-N45 post-operation was higher than that pre-operation (P<0.0 001).The postoperative change of P37-N45 amplitude was negatively correlated with age (r=-0.45 at left side while r=-0.44 at right side,both P<0.01) and the trend was more obvious in FT with low conus (r=-0.51 at left side with P<0.05 while r=-0.57 at right side with P<0.01).Conclusion Loosening operation relieves the clinical symptoms of FT patients.P37-N45 amplitude hints at potential neurological impairment.Surgery at an earlier age may accelerate the recovery of impaired neurological function.
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Memo
收稿日期:2022-4-30。
基金项目:上海市2020年度"科技创新行动计划"(20Y11905800);上海交通大学"交大之星"计划医工交叉研究基金(YG2021QN117);上海市儿童医院院级课题国家自然科学基金培育专项(2020YGZQ05)
通讯作者:肖波,Email:xiao977@hotmail.com