下肢体体感觉唤起的潜能预测了完全创伤性椎脊髓损伤的功能结果
Anthony K Chiu1, Sabrina P Bustos2, Ovais Hasan1
1Division of Spine Surgery, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA.
World neurosurgery
|November 26, 2023
概括
体感唤起潜能 (SSEP) 可以预测部脊髓创伤 (tCSCI) 的结果. 在手术期间检测下肢SSEP与更好的运动得分的改善相关,特别是在完全受伤的情况下.
科学领域:
- 神经外科 神经外科
- 神经学 神经学
- 脊髓损伤研究 脊髓损伤研究
背景情况:
- 创伤性椎脊髓损伤 (tCSCI) 是令人衰弱的,需要准确的早期预后来规划治疗.
- 当前的预后因素 (体检,成像,人口统计) 有局限性,导致结果变化.
- 体感唤起潜能 (SSEPs) 提供了一种潜在的工具,可以提高tCSCI的预后准确性.
研究的目的:
- 评估体感唤起潜能 (SSEP) 的预后价值,用于预测部脊髓创伤 (tCSCI) 患者的功能结果.
主要方法:
- 对79名患有tCSCI的患者 (≥18岁) 进行前性收集的数据的回顾性分析,这些患者接受了后部宫减压和稳定.
- 进行了手术内神经监测,包括SSEPs.
- 使用美国脊椎损伤协会 (ASIA) 损伤量表 (AIS) 等级和ASIA运动分数评估的功能结果,通过t测试,奇方测试和回归分析进行分析.
主要成果:
- 在完全伤害中检测到的下肢SSEP与更高的ASIA运动分数 (P=0.002) 和更大的改善 (P=0.009) 相关联.
- 与AIS A或B相比,患有不完整的AIS等级C损伤的患者表现出更高的等级转换率 (P=0.019) 和运动得分改善率 (P=0.010).
- 在手术期间检测SSEP与术后ASIA运动得分的改善有关.
结论:
- 在初始tCSCI手术期间检测下肢SSEP预测ASIA运动得分的术后改善更大.
- 这种预后关联对于患有完全创伤性椎脊髓损伤的患者尤为重要.
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