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在脊柱外科手术中,手术内伸缩肌肉MEP在脊柱外科手术中的作用

Paolo Costa¹, Alessandro Borio², Sonia Marmolino²

¹Department of Neurosciences and Mental Health, Section of Clinical Neurophysiology, Città della Salute e della Scienza, Turin, EU, Italy. pacst@fastwebnet.it.

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

|June 19, 2023

概括

在脊柱外科手术过程中,延伸指骨 (EDB) 肌肉的运动唤起潜能 (m-MEPs) 显示出优越的记忆能力和类似的稳定性,与前 (TA) 和体幻觉 (AH) 相比. EDB为监测脊髓完整性提供了一个有价值的替代品或补充.

科学领域:

神经外科神经外科
神经生理学神经生理学
脊髓监测脊髓监测脊髓监测

背景情况:

在手术期间检测可逆脊髓损伤时,手术内肌肉运动唤起潜能 (m-MEPs) 是至关重要的.
下肢的m-MEP通常记录在绑架者幻觉 (AH) 和前 (TA) 肌肉中.

研究的目的:

为了评估延伸短肌 (EDB) 作为替代或额外的肌肉在脊柱外科手术中的手术内m-MEP记录的适用性.
确定在未经选择的患者群体中用于脊髓监测的最可靠和最稳定的肌肉反应.

主要方法:

在107次脊椎手术中,使用针头电极记录了TA,AH和EDB肌肉中的手术内m-MEP.
在录音中使用过骨电气诱导的m-MEPs.

主要成果:

在93.5%的病例 (100/107) 中,至少有一个下肢m-MEP的总体可监测性得到了实现.
肌肉反应从基线到手术结束的持续时间为TA的88.7%,AH的89.8%,EDB的93.8%.
与TA相比,EDB表现出优越的记录能力和与AH相比的稳定性.

结论:

延伸指短 (EDB) 肌肉m-MEPs提供了优越的记忆能力和与传统肌肉 (TA,AH) 相比的稳定性,用于手术内脊髓监测.
在脊柱外科手术中,EDB可以作为下肢m-MEP记录的替代或补充肌肉.
记忆能力的差异可能源于皮层或脊柱运动神经元刺激性和缺血敏感性.

关键词:

绑架者的幻觉延伸器是指甲骨 (digitorum brevis) 的延伸器.在手术期间的肌肉运动唤起了潜在的潜能.脊柱外科手术脊柱外科手术在前前的前.

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