Neurophysiological monitoring in treatment of lumbar disc herniation with percutaneous spinal endoscopy under general anesthesia
10.3760/cma.j.cn115354-20200528-00418
- VernacularTitle:神经电生理监测辅助全麻经皮脊柱内镜治疗腰椎间盘突出症
- Author:
Shishui LIN
1
;
Shangjun GAO
;
Feng LU
;
Cheng LIN
;
Kefeng LIN
;
Shiguo ZHOU
;
Yubin ZHANG
Author Information
1. 福建医科大学省立临床学院（福建省立金山医院）骨科，福州 350001
- Keywords:
Neurophysiological monitoring;
Lumbar disc herniation;
Minimally invasive surgery
- From:
Chinese Journal of Neuromedicine
2020;19(10):1035-1039
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of percutaneous endoscopic lumbar discectomy (PELD) with the aid of neurophysiological monitoring under general anesthesia.Methods:From August 2016 to October 2019, 58 patients underwent PELD under general anesthesia were selected in our hospital; 30 were via transformational approach and 28 were via interlaminar approach. The whole operative procedures were performed under continuous monitoring of spontaneous electromyography (SEMG), and the peak value, waveform and motor unit of SEMG at the surgical side were observed. The clinical outcomes were evaluated by visual analogue scale (VAS) and Oswestry disability index (ODI).Results:PELD was successfully performed in all 58 patients. Abnormal SEMG reactions were recorded in 8 patients (13.8%), manifested as clustered or frequent high amplitude action potentials; 5 patients (16.7%, 5/30) were via transformational approach and 3 (10.7%, 3/28) were via interlaminar approach. Two patients relapsed at 3 and 6 weeks after surgery, respectively; one was treated with PELD again and the other one was treated with lumbar fusion and instrument fixation. The pain at the lumbago and leg was alleviated obviously after surgery in the 56 patients; the VAS scores were 7.43±1.32, 2.55±0.87 and 1.59±0.87 before surgery, and 3 d and 3 months after surgery, respectively, with significant differences ( P<0.05); the mean ODI before surgery and 3 months after surgery were 67.36±7.13 and 12.39±5.48, respectively, with significant difference ( P <0.05). Conclusion:PELD with the aid of neurophysiological monitoring under general anesthesia is safe and reliable, which can achieve good clinical efficacy.
