Efficacy of combined monitoring with TES-MEP and CSEP during anterior or posterior surgery for cervical spondylitic myelopathy
10.3760/cma.j.issn.1001-8050.2011.06.005
- VernacularTitle:脊髓型颈椎病前、后路手术中经颅电刺激运动诱发电位与皮层体感诱发电位的联合监护作用
- Author:
Yuguang CHEN
;
Xinsheng PENG
;
Zhaomin ZHENG
;
Yong WAN
;
Junlin YANG
;
Liyan CHEN
;
Fobao LI
- Publication Type:Journal Article
- Keywords:
Cervical spondylosis,myelopathy;
Electrical stimulation;
Evoked potentials,motor;
Evoked potentials,somatosensory;
Combined monitoring
- From:
Chinese Journal of Trauma
2011;27(6):497-500
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate of the efficacy of transcranial electrical stimulation motor evoked potential (TES-MEP)in combination with cortical somatosensory evoked potential (CSEP) monitoring during the anterior or posterior approach spinal surgery for cervical spondylitie myelopathy (CSM).Methods TES-MEP on the bilateral anterior tibial muscle and flexor hallucal brevis and thenar muscles and CSEP on the bilateral posterior tibial nerve and ulnar nerve were observed simultaneously in 135 patients during spinal surgery.Intravenous anesthesia was employed in all the patients.The results of TES-MEP,CSEP and combined monitoring were analyzed statistically.Pre-oporative and post-operative motor and sensory functions of the spinal cord were compared. Result Success rate of TES-MEP,CSEP and the combined monitoring was 87.4%.97.8%and 100%,respectively.Out of 135 patients,nine patients (6.7%) were detected with the positive evoked potentials due to surgical operation.The sensitivity of TES-MEP and CSEP in assessing the spinal cord motor function was 100%and 83.3%,respectively,while that in assessing the spinal cord sensory function was 77.8%and 100%,respectively.The sensitivity and specificity of the combined monitoring was both 100%. Conclusion The successful detection rate and accuracy of the combined monitoring for spinal cord function are apparently higher than that of simple TES-MEP or CSEP.The causes for operative maneuvers evoking a positive evoked potential include complete anterior decompression of the spinal canal,intervertebral bone graft,laminoplasty for OPLL and hematoma compression caused by a failed drainage in a posterior-anterior approach surgery.
