Wang Shujie,Ren Zhifu,He Fang,et al.Effectiveness analysis of intraoperative electrophysiological monitoring for early-onset scoliosis[J].Journal of Clinical Pediatric Surgery,,19():120-124.[doi:10.3969/j.issn.1671-6353.2020.02.006]
Effectiveness analysis of intraoperative electrophysiological monitoring for early-onset scoliosis
- Keywords:
- Scoliosis; Transcranial Electric Motor Evoked Potential; Somatosensory Evoked Potential; Hemivertebra Resection; Vertebral Column Resection; Total Intra Venous Anesthesia
- CLC:
- R726.8;R682.3;R338.8
- Abstract:
- Objective To explore the feasibility of combining intraoperative transcranial electric-stimulation motor evoked potential (TceMEP) and somatosensory evoked potentials (SSEP) monitoring during spinal osteotomy of early-onset scoliosis (EOS) and analyze the characteristics of intraoperative electrophysiological monitoring.Methods From September 2015 to December 2016,a total of 20 EOS children with a mean age of (2.65±0.11) years and 120 children of adolescent idiopathic scoliosis (AIS) with a mean age of (13.9±0.51) years were retrospectively reviewed.Transcranial motor evoked potentials (TceMEPs),somatosensory evoked potentials (SSEPs),free-run intra-operative electromyography (free-run EMG) and a standardized anesthesia protocol were applied for intraoperative electrophysiological monitoring.Results The procedures included posterior hemivertebra or vertebra column resection,instrumentation and short fusion surgery.And 95.0% (19/20) cases had stable and reliable intra-operative baseline levels of SSEP and TceMEP.One 2-year-old child with a body weight of 9 kg failed to achieve a baseline TceMEP until osteotomy.And AIS children underwent posterior instrumentation deformity correction and bone graft fusion.The average baseline amplitude of TceMEP was markedly lower than that of EOS[(88.7±21.9)(27-278) vs (346.7±24.2) μV] (t=2.162,P<0.01).The differences were statistically significant.Conclusion Combining TceMEP,SSEP and free-run EMG monitoring is both feasible and effective.It provides accurate information for surgical teams to prevent the postoperative occurrences of neurological deficits.
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Memo
收稿日期:2019-12-16。
通讯作者:仉建国,Email:jgzhang_pumch@yahoo.com