Xiao Bo,Jiang Wenbing,Wang Junlu,et al.Application of evoked electromyography in selecting spinal nerve roots during selective dorsal rhizotomy[J].Journal of Clinical Pediatric Surgery,,21():901-906.[doi:10.3760/cma.j.cn101785-202206009-001]
Application of evoked electromyography in selecting spinal nerve roots during selective dorsal rhizotomy
- Keywords:
- Cerebral Palsy; Paraparesis; Spastic; Rhizotomy; Neurophysiological Monitoring; Electromyography
- Abstract:
- Partially resecting some spinal dorsal nerve roots can effectively lower abnormally heightened excitability of α motor neurons in anterior horns of spinal cord,directly causing corresponding muscle spasticity in patients with spastic cerebral palsy.Therefore such surgical procedure has potentials of reducing muscle tone of spastic muscles and improving motor functions.Due to the fact that several scores of root candidates are associated with sensory input from lower extremities in each case,precisely "selecting" roots for sectioning stays always at the core of surgery.Evoked electromyography (EMG),as one modality of intra-operative neurophysiological monitoring,is offering a practical approach to accomplish the task of "precise selection" of nerve root.For acquiring stable and interpretable evoked EMG data during selective dorsal rhizotomy (SDR),some requirements should be fulfilled.For example,an appropriate depth of anesthesia,muscle group selection for monitoring and proper electrical stimulation parameters.Train and single-pulse stimulation are currently the two most practiced stimulation patterns.Applying different stimulation patterns may lead to a different selection of nerve roots for resecting.Our objective was to formulate an intra-operative evoked EMG interpretation protocol of guiding more precisely to attain the goal of "selection" during SDR.
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Memo
收稿日期:2022-6-6。
基金项目:上海市科学技术委员会"科技创新行动计划"项目(20Y11905800)
通讯作者:詹琪佳,Email:hanbing_1125@163.com