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在非脊柱外科手术期间危险的脊柱的手术内神经监测:一个9年的回顾

Madeleine E Jackson¹, Amanda K Galambas², Jennifer M Bauer^1,3

¹Department of Orthopaedics and Sports Medicine, University of Washington.

Journal of pediatric orthopedics

|September 20, 2023

概括

在接受非脊柱手术的高风险脊柱异常患者的内科神经监测 (IONM) 发现了潜在的脊髓损伤. 这种方法有助于预防严重儿科病例的永久性神经缺陷.

科学领域:

神经学神经学
麻醉学麻醉学
儿科整形外科儿科整形外科

背景情况:

脊髓异常患者在麻醉期间面临脊髓损伤的风险.
为管理这些高风险患者,建立了脊柱危险 (SAR) 计划.
术内神经监测 (IONM) 是对高风险个体的关键预防措施.

研究的目的:

评估IONM在脊柱异常患者的非脊柱手术中的有效性.
为了确定潜在的脊髓损伤的避免率.
在IONM期间分析临床结果和警报特征.

主要方法:

对机构SAR计划 (2011-2019) 的回顾性审查.
根据IONM进行的非脊柱手术的分析.
检查IONM警报和患者的结果.

主要成果:

10%的SAR标记患者接受了IONM对非脊柱手术的建议.
在接受102项手术的57名患者中发生了10例IONM警报.
由于无法解决的警报,两例病例被中止; 一名患者出现过渡性缺陷. 没有报告任何永久性伤害.

结论:

在高风险的脊柱异常患者中,接受非脊柱手术的IONM产生了10%的警觉率,没有永久的神经缺陷.
这种监测策略确定并解决了潜在的脊髓损伤.
对处于危险的儿科患者推IONM对于预防神经损伤至关重要.

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