Application of intraoperative neurophysiological monitoring in cervical intraspinal tumor surgery
10.3760/cma.j.issn.0253-2352.2016.24.007
- VernacularTitle:术中神经电生理监测在颈椎管内肿瘤手术中的应用
- Author:
Hong MA
;
Bing WANG
;
Guohua LYU
;
Xiang'an YANG
;
- Keywords:
Cervical vertebrae;
Neoplasms;
Evoked potentials,somatosensory;
Evoked potentials,motor;
Electromyography
- From:
Chinese Journal of Orthopaedics
2016;36(24):1574-1580
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficiency of intraoperative neurophysiological monitoring in cervical spinal tumor surgery.Methods Retrospective case-control study comparing 23 cervical spinal tumor patients received surgery under neurophysiological monitoring (case) and 23 cases without neurophysiological monitoring (control).Results All of 46 cases,there were no significant differences of age,gender and preoperative neurological function.Duration of operation and estimated blood loss in the IONM cohort was less than the control group with significant difference.The preoperative JOA score of IONM group and control group were 12.0±2.4 and 12.7±2.1,with no significant difference.The postoperative JOA score of each group were 15.0±1.5 and 15.2±1.7,with no significant difference.The rate of cervical cord neurological improvement of IONM group was higher than control group,but there was no significant difference.In the IONM cohort,abnormal signal appeared in 8 cases,with 1 case developed new postoperative deficit,and the sensitivity and specificity of SEP were 100％ and 77.3％,the sensitivity and specificity of MEP were 100％ and 86.4％.Compared with preoperative SEP,4 cases showed major improvement (baseline increase ＞ 40％),2 cases showed moderate improvement (baseline increase:15％-40％).The coincidence rate of the SEP improvement and the AISA grade was 66.7％.Conclusion IONM could reduce the duration of operation and intraoperative blood loss.Changes of IONM were correlated with postoperative neurological function improvement.
