Feng Lei,Zhang Xuejun,Gao Jingchun,et al.Application of multi-modal intraoperative monitoring technology during posterior reduction and fusion fixation of lumbar spondylolisthesis in children[J].Journal of Clinical Pediatric Surgery,,20():582-587.[doi:10.12260/lcxewkzz.2021.06.014]
Application of multi-modal intraoperative monitoring technology during posterior reduction and fusion fixation of lumbar spondylolisthesis in children
- CLC:
- R681.5;R726.1
- Abstract:
- Objective To explore the application value of multi-modal intraoperative neuromonitoring during reduction and fusion of lumbar spondylolisthesis in children.Methods Retrospective analysis was performed for 19 hospitalized cases of lumbar spondylolisthesis from January 2018 to November 2019.There were 2 boys and 17 girls with an average age of (9.1±2.7) years.During posterior reduction,fusion and fixation,somatosensory evoked potential (SEP),motion evoked potential (MEP) and free-run electromyography (EMG) were monitored simultaneously.Declines of MEP wave amplitude >80% and SEP amplitude >50% or latent period extending by 10% were diagnosed as positive changes.And myoelectric response indicated that nerve root was provoked as a positive change.Results The SEP/MEP amplitudes with excellent monitoring value and repeatability were successfully obtained intraoperatively in all 19 cases with a success rate of 100%.The corresponding intraoperative EMG monitoring showed electromyographic response upon touching,pushing and pulling nerve root and the positive rate was 100%.The amplitude or latency of SEP/MEP failed to reach the warning threshold.In 2 cases (10.5%),there was a continuous explosive myoelectric reaction during operation.Also a continuous unilateral explosive EMG reaction was detected.Then operation was suspended in time and EMG reaction significantly declined.EMG reaction occurred again during operation.After operation,nerve burn pain of unilateral lower limb occurred and muscle strength remained normal.The symptoms disappeared within 3 months.Conclusion The method of multi-mode intraoperative neuromonitoring during lumbar spondylolisthesis can both record the integrity of spinal cord and the functional status of nerve root in real time.And it may lower the intraoperative risks of injury of spinal cord and nerve root and improve operative safety.
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Memo
收稿日期:2019-12-18;。
基金项目:北京市医院管理局"扬帆"计划临床技术创新项目（编号：XMLX201818）
通讯作者:张学军,Email:zhang_x_j04@163.com