Combined application of two somatosensory evoked potential techniques at various recording point for monitoring the onset of stretch spinal injury during rhachial orthomorphia
- VernacularTitle:两种体感诱发电位联合应用组合不同记录点监测预防脊柱矫形术中牵张性脊髓损伤的发生
- Author:
Jiemin HE
;
Yong TANG
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2005;9(37):164-165
- CountryChina
- Language:Chinese
-
Abstract:
BACKROUND: Because the cortical somatosensory evoked potential(CSEP) is easily affected by the anaesthesia drugs, so it needs to be combined with the subcortex somatosensory evoked potential (subcortical SEP)which is less affected by the junk to monitoring the spinal orthomorphia so as to increase the accuracy.OBJECTIVE: To monitor the onset of stretch spinal injury during rhachial orthomorphia with Combined application of subcortical SEP and CSEP.DESIGN: A comparative study of two kinds of evoked potential.SETTING: Department of Orthopaedics of the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Totally 104 patients with spinal orthomorphia ,including 40 males and 64 females, aged from 5 to 19 years, were selected from the Department of Orthopaedics of Sun Yi-xian Hospital of Sun Yat-sen University from July 1997 to December 2001.INTERVENTIONS: A Nicolet Viking Ⅳ (NICDLET Company, USA) with intraoperativemonitoring software was used to Record the wave of subcortical SEP and CSEP. The peak and after-following peak of the median N45and tibial P37 cortical responses were tagged manually for peak latency and peak-to-peak amplitude measurements. Reduction of more than 50% in SEP amplitude compared with the baselines measurement was defined as deterioration.MAIN OUTCOME MEASURES: Changes of CSEP and subcortical SEP during the surgery.RESULTS: Data of all 104 patients was entered the final analysis. Among 104 cases, 31 had positive cortex somatosensory evoked potential, 11 had positive infra-cortex somatosensory evoked potential, meanwhile, 3 cases changed into normal after relative treatment, which was related with operation. Accurate of cortex recorded point was 75%, under cortex 92.2%, and combination of cortex and infra-cortex 96.7%.CONCLUSION: The SEP is easily affected by the anaesthesia drugs, but it has good signals to record, however, the subcortical SEP is the contrary condition. The monitoring by combined application of CSEP and subcortical SEP during the spinal surgery can greatly increase the reliability of result.
