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术内神经监测在后端内镜宫减压中的使用:它可以减少并发症吗?

Vit Kotheeranurak¹, Peem Sarasombath², Khanathip Jitpakdee³

¹Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand. vitinspine@gmail.com.

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

|February 21, 2026

概括

在后端内镜宫减压 (PECD) 手术期间的手术内神经监测 (IONM) 增强了决策和安全性,尽管它不能预测所有结果. 所有患者都表现出改善的症状,无论IONM使用.

科学领域:

神经外科神经外科
脊柱外科手术脊柱外科手术
整形外科整形外科整形外科

背景情况:

后端内学宫解压 (PECD) 用于宫脊髓性根系病变 (CSR) 和核脉 (HNP).
在PECD中,手术内神经监测 (IONM) 的实用性仍然存在争议,尽管它具有实时神经评估的潜力.

研究的目的:

评估在接受PECD的患者中IONM的影响和必要性.
探索改善IONM在椎脊椎手术中的利用的解决方案.

主要方法:

140名单段CSR或HNP患者的回顾性队列研究 (2020-2023年).
70名PECD+IONM患者与70名仅使用PECD的患者进行比较.
评估神经状态,IONM数据,手术持续时间,并发症,部残疾指数 (NDI),视觉模拟尺度 (VAS) 和修改的MacNab标准.

主要成果:

所有140名患者均表现出术后神经改善,没有缺陷.
在VAS,NDI和MacNab标准的显著改善在12个月后在两个组中都观察到.
在60名患者中观察到IONM变化,10名患者没有变化,但所有患者都取得了积极的结果.

结论:

IONM有助于手术决策和外科医生的信心,即使对术后缺陷的预测价值有限.
IONM报警对于识别和管理潜在并发症至关重要,提高了患者的安全.
预计IONM技术的进步将进一步优化骨科手术的结果.

关键词:

椎椎是椎的第一个部分.在手术内进行监测.手术内镜是指手术内镜.

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