Wang Yongqiang,Chen Min,Wang Hangzhou.. Application of electromyogram monitoring during spinal cord loosening for tethered cord syndrome in children.[J].Journal of Clinical Pediatric Surgery,,17():922-926.
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 Application of electromyogram monitoring during spinal cord loosening for tethered cord syndrome in children.

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第17卷 Number: 2018 12 Page: 922-926 Column: 论著 Date of publication: 2018-12-18
Author(s):
 Wang Yongqiang; Chen Min; Wang Hangzhou.
 Department of Neurosurgery,Affiliated Childrens Hospital,Soochow University,Suzhou 215025.
Keywords:
 ; Tethered Spinal Cord;  Electromyograph;  Neuroelectrophysiological Monitoring;  Child
Document code:
A
Abstract:
 ObjectiveTo explore the effect of electromyography (EMG) monitoring during spinal loosening for tethered cord syndrome (TCS) in children.MethodsFrom November 2017 to June 2018,clinical data were reviewed for 61 children of tethered cord diagnosed neurosurgically.Intraoperative EMG monitoring was performed and postoperative followups were conducted.ResultsThe nerve roots of L5,S1 and S2 were identified by EMG monitoring.Affected side of one patient with a zero level of muscle strength of right lower extremity was significantly lower than that of opposite side.However,induced EMG recording could be used.During operation,it prompted the operator to avoid continuous overstretch myoelectric reflex.Fork bipolar probe was employed for detecting the correlation between adhesion site and nerve roots and identifying the direction of each nerve root.The postoperative followup period was 3 to 11 months.Urinary retention occurred in one case (lipoma type),but recovered to the preoperative period after 14day urinary catheterization.Among 19 cases of dyspraxia,the outcomes were improvement (n=5) and no change/aggravation (n=14);among 11 cases of lower limb dysfunction,improvement (n=9) and no change/aggravation (n=2).The ratio of CORD/SAC was (0.78±0.03) before surgery and (0.41±0.02) after surgery.And the difference was statistically significant (t=12.78,P<0.001).ConclusionIntraoperative EMG can monitor intraoperative nerve interference in realtime,identify nerve root adhesion,detect inactivated nerve root,reduce intraoperative nerve damage and release tethered cord.
Last Update: 2018-12-18