EFFICACY OF MULTIMODALITY SPINAL-CORD MONITORING DURING SURGERY FOR NEUROMUSCULAR SCOLIOSIS

被引：53

作者：

OWEN, JH ^{[1
]}

SPONSELLER, PD ^{[1
]}

SZYMANSKI, J ^{[1
]}

HURDLE, M ^{[1
]}

机构：

[1] JOHNS HOPKINS UNIV HOSP,DEPT ORTHOPED SURG,BALTIMORE,MD 21287

来源：

SPINE | 1995年 / 20卷 / 13期

关键词：

Motor-evoked potentials; Neuromuscular scoliosis; Somatosonsory-evoked potentials;

D O I：

10.1097/00007632-199507000-00007

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Design. This study determined the relative efficacy of somatosensory-evoked potentials and motor-evoked potentials in monitoring spinal cord function during surgery for patients with idiopathic versus neuromuscular scoliosis. Objectives. To determine whether patients with idiopathic versus neuromuscular scoliosis demonstrate significantly different somatosensory-evoked potentials and motor-evoked potentials recorded during surgery. Summary of Background Data. Ashkenaze et al (1993) and others have reported that cortical somatosensory-evoked potentials are unreliable when used to monitor spinal cord function in patients with neuromuscular scoliosis. It was recommended that other neurophysiologic tests be used. Methods. Somatosensory-evoked potentials and motor-evoked potentials were recorded from two groups of patients: those with idiopathic scoliosis and those with neuromuscular scoliosis. Somatosensory-evoked potentials were obtained before and during surgery. Motor-evoked potentials were obtained during surgery. Normal variability, as indicated from idiopathic scoliotic results, was compared with data obtained from patients with neuromuscular scoliosis. Motor-evoked potentials and somatosensory-evoked potentials were obtained sequentially during the duration of surgery. Results. Single-channel cortical somatosensory-evoked potentials demonstrated a 27% positive rate, which was consistent with results (28%) from Ashkenaze et al. The use of multiple recording sites for the somatosensory-evoked potentials and the addition of motor-evoked potential procedures indicated that a reliable response could be obtained in more than 96% of the patients. It also was found that cortical somatosensory-evoked potentials were more affected by anesthetic agents when recorded from patients with neuromuscular scoliosis compared with patients with idiopathic scoliosis. Conclusions. Single-channel cortical somatosensory-evoked potentials demonstrated a high level of unreliability, which reduced their clinical effectiveness. However, by using multiple recording sites with the somatosensory-evoked potentials and by administering motor-evoked potential procedures, it was possible to monitor spinal cord function in neuromuscular patients and avoid postoperative neurologic deficits.

引用

页码：1480 / 1488

页数：9

共 13 条

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