A comparative study of the intraoperative neurophysiological monitoring results during 3-column os-teotomy surgery in severe congenital scoliosis with or without intraspinal anomalies
10.3969/j.issn.1004-406X.2025.04.03
- VernacularTitle:伴与不伴椎管内异常的重度先天性脊柱侧凸三柱截骨矫形术中神经电生理监测结果的对比研究
- Author:
Dengxu JIANG
1
;
Yuanxian LENG
1
;
Fei WANG
1
;
Deng ZHAO
1
;
Rui ZHONG
1
;
Zhong ZHANG
1
;
Yijian LIANG
1
;
Zhengjun HU
1
Author Information
1. 成都市第三人民医院骨科 610031
- Publication Type:Journal Article
- Keywords:
Congenital scoliosis;
Intraspinal anomalies;
3-column osteotomy;
Intraoperative neurophysiological monitoring
- From:
Chinese Journal of Spine and Spinal Cord
2025;35(4):350-358
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To compare the intraoperative neurophysiological monitoring(IONM)results during 3-column osteotomy surgery in severe congenital scoliosis(CS)patients with or without intraspinal anomalies,and to explore the effect of intraspinal anomaly on the incidence of IONM alarm events and postoperative out-comes in CS patients.Methods:Clinical data of patients with severe CS who underwent 3-column osteotomy surgery in our hospital from September 2020 to May 2023 were retrospectively analyzed.The patients were divided into two groups according to whether combined with intraspinal anomalies.The basic information,the latency and amplitude of somatosensory evoked potentials(SSEPs)of both lower extremities,amplitude of tran-scranial electric motor evoked potentials(TCeMEPs),as well as the sensitivity and specificity of multimodal IONM were compared between the two groups.The incidence of IONM alarm events and postoperative out-comes were analyzed.Results:A total of 37 patients who met the criteria were included in the study,of which 14 patients combined with intraspinal anomalies,including 8 cases of syringomyelia,2 case of tethered cord,1 case of diastematomyelia,1 case of diastematomyelia combined with tethered cord,and 2 cases of sy-ringomyelia combined with tethered cord.The latency of SSEPs-P3 7 in the concave side lower extremity of CS patients with intraspinal anomalies was significantly longer than that of CS patients without intraspinal anomalies(40.9±3.3ms vs 38.0±3.7ms,P=0.03).In addition,the sensitivity and specificity of multimodal IONM were comparable between the two groups.There was no significant difference in the incidence of abnormal SSEPs,the incidence of IONM alarm events and the incidence of postoperative neurological symptoms between the two groups(P＞0.05).Conclusions:Multimodal IONM provides excellent monitoring effects in severe CS paitents undergoing 3-column osteotomy surgery.The latency of SSEPs-P37 in the concave side lower ex-tremity of CS patients with intraspinal anomalies was significantly longer than that of CS patients without in-traspinal anomalies.Intraspinal anomalies don't increase the incidence of intraoperative IONM alarm events or the incidence of postoperative neurological complications.
