Liu Wanyou,Qiu Junyin,Shi Benlong,et al.Impact of curve patterns on intraoperative neurophysiological monitoring during correction surgery for adolescent idiopathic scoliosis[J].Journal of Clinical Pediatric Surgery,2022,21(10):936-940.[doi:10.3760/cma.j.cn101785-202203027-007]
弯型对青少年特发性脊柱侧凸矫形手术中神经电生理监测的影响研究
- Title:
- Impact of curve patterns on intraoperative neurophysiological monitoring during correction surgery for adolescent idiopathic scoliosis
- Keywords:
- Scoliosis; Pathology; Neurosurgical Procedures; Orthopedic Procedures; Neurophysiological Monitoring; Adolescent
- 摘要:
- 目的 比较分析不同弯型青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患儿矫形手术中神经电生理监测(intraoperative neurophysiological monitoring,IONM)结果,探讨弯型对AIS患儿IONM监测的影响。方法 回顾性分析2015年6月至2019年12月于南京大学医学院附属鼓楼医院脊柱外科行手术治疗的400例女性AIS患儿临床资料,按照弯型,分成单胸弯组、胸腰弯组/腰弯组、双胸弯组及胸腰双弯组,每组各100例。比较组内及组间左右侧体感诱发电位(somatosensory evoked potential,SSEP)和经颅电刺激运动诱发电位(transcranial electric motor evoked potential,TCeMEP)的潜伏期及波幅差异,计算不同弯型病例组间不对称性SSEP的发生率。结果 单胸弯组及双胸弯组组内左右侧SSEP及TCeMEP的潜伏期和波幅比较,差异均无统计学意义(P＞0.05)。胸腰弯/腰弯组左侧TCeMEP潜伏期较右侧显著延长(P=0.032),胸腰双弯组左侧SSEP-P37潜伏期(P=0.002)和SSEP-N45潜伏期(P<0.001)较右侧显著延长。不对称性SSEP的发生率:单胸弯组为33.0%,胸腰弯/腰弯组为34.0%、双胸弯组为27.0%、胸腰双弯组为37.0%(P=0.495),差异无统计学意义。结论 AIS患儿矫形术中双下肢SSEP和TCeMEP的潜伏期和波幅存在不对称现象。弯型不是AIS患儿矫形术中不对称性SSEP的风险因素。
- Abstract:
- Objective To compare the results of intraoperative neurophysiological monitoring (IONM) during posterior spinal correction surgery for adolescent idiopathic scoliosis (AIS) patients with different curve patterns and examine the impact of curve pattern on IONM results.Methods From June 2015 to December 2019,400 AIS females undergoing operations were retrospectively reviewed,including single thoracic curve (ST,n=100),thoracolumbar/lumbar curve (TL/L,n=100),double thoracic curve (DT,n=100) and double major curve (DM,n=100).Absolute values of latency and amplitude for somatosensory evoked potential (SSEP) and transcranial electric motor evoked potential (TCeMEP) between bilateral lower limbs and the incidence of asymmetric SSEP between patients with different curve patterns were compared.Results The latencies and amplitudes of SSEP and TCeMEP demonstrated marked asymmetry between left and right lower limbs (P>0.05).The latency of TCeMEP was longer in left lower limb than right lower limb in TL/L group (P=0.032) while the latencies of SSEP-P37(t=3.166,P=0.002) and SSEP-N45 (t=4.089,P<0.001) were significantly longer in left lower limb than right lower limb in DM group.The incidence of asymmetric SSEP was 33% in ST group,34% in TL/L group,27% in DT group and 37% in DM group(P=0.495).Conclusion Asymmetric latencies and amplitudes of SSEP and TCeMEP between bilateral lower limbs are frequently noted in AIS patients.Therefore curve pattern is not a risk factor for asymmetric SSEP in AIS.
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备注/Memo
收稿日期:2022-3-10。
基金项目:江苏省自然科学基金青年基金(BK20170126);南京市医学科技发展资金一般性课题(CZLB1480-2020)
通讯作者:朱泽章,Email:zhuzezhang@126.com