Wu Tian,Su Jun,Li Hao,et al.Application of neurophysiological monitoring in spinal canal space-occupying disease surgery in children[J].Journal of Clinical Pediatric Surgery,,21():923-928.[doi:10.3760/cma.j.cn101785-202204097-005]
Application of neurophysiological monitoring in spinal canal space-occupying disease surgery in children
- Abstract:
- Objective To explore the early warning effect of intraoperative neurophysiological monitoring on spinal cord and nerve root functional injury in children with intraspinal space-occupying diseases.Methods From January 2019 to April 2022,retrospective review was performed for clinical data of 75 children hospitalized with space-occupying disease in spinal canal at Hunan Children’s Hospital.They were divided into three age groups of<1 year (A,n=32),1-3 year (B,n=13) and >3 year (C,n=30).Neurophysiological monitoring was applied intraoperatively.Defecation,urination and limb function were evaluated at Day 14 post-operation and the correlation was examined between intraoperative monitoring and postoperative symptom changes.Results The baseline values of somatosensory evoked potential (SSEP) and transcranial electrical motor evoked potential (TCeMEP) in group C were higher than those of group A/B (P<0.05).Intraoperative abnormal amplitude of TCeMEP was 15.7%(9/57) and abnormal amplitude of SSEP 26.4%(9/34).It was correlated a decline of central venous pressure (n=1) and anesthesia (n=2).Amplitude recovered after symptomatic treatment.Six cases were correlated with intraoperative handling operation.Two of them stopped operation and amplitude normalized after further treatment.The remaining 4 cases showed lower muscle strength accompanied by local limb numbness and pain.Symptoms gradually improved within 14 days post-operation.Conclusion TCeMEP and SSEP offer excellent clinical application values for intraspinal surgery in children,especially those aged over 3 years.Changes in monitoring parameters hint at nerve damage caused by surgical procedures and can effectively minimize irreversible damage to nerve function.
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Memo
收稿日期:2022-4-30。
基金项目:湖南省出生缺陷协同防治科技重大专项(2019SK1010)
通讯作者:吴水华,Email:292454021@qq.com