Fan Juan,Wang Xiaodong,Miao Suhua,et al.Effect of intraoperative neurophysiological monitoring on lumbar 5 selective posterior rhizotomy in patients with cerebral palsy[J].Journal of Clinical Pediatric Surgery,,21():917-922.[doi:10.3760/cma.j.cn101785-202205022-004]
Effect of intraoperative neurophysiological monitoring on lumbar 5 selective posterior rhizotomy in patients with cerebral palsy
- Keywords:
- Cerebral Palsy; Rhizotomy; Neurophysiological Monitoring; Child
- Abstract:
- Objective To explore the effect of intraoperative electrophysiological monitoring on transection proportion of lumbar 5 spinal nerve posterior root,examine the effect on muscle tonus of hamstring,and triceps muscle groups and provide reliable rationales for the significance of intraoperative electrophysiological monitoring on multi-level selective spinal nerve posterior rhizotomy.Methods From November 2020 to March 2022,clinical data was retrospectively reviewed for 40 cerebral palsy patients undergoing selective posterior rhizotomy of lumbar 5 segment.According to the absence and presence of intraoperative neurophysiological monitoring,they were divided into two groups of non-monitoring (n=13) and monitoring (n=27).Ratio of lumbar 5 spinal nerve posterior root transection,preoperative muscle tension and improvement rate of muscle tension were compared between two groups.Results The proportion of left spinal nerve posterior root transection in non-monitoring group was (57±11)% and (46±10)% in monitoring group.The difference had statistical significance (P<0.05).The proportion of right posterior spinal nerve root transection was (53±2)% in non-monitoring group and (39±3)% in monitoring group.The difference was statistically significant (P<0.05).No significant inter-group difference existed in muscle tension on preoperative surface electromyography (P>0.05).No significant inter-group difference existed in improvement rate of bilateral hamstring and triceps muscle tension (P>0.05).Conclusion Intraoperative neurophysiological monitoring of children undergoing selective posterior rhizotomy may reduce the proportion of rhizotomy without affecting the improvement rate of muscle tone.It minimizes postoperative complications and unnecessary nerve injuries.
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Memo
收稿日期:2022-5-27。
基金项目:北京市科技项目(Z211100003521006)
通讯作者:王世杰,Email:wjr215@163.com