Cioni B, Meglio M, Rossi G F
Istituto di Neurochirurgia, Università Cattolica, Roma, Italy.
Arch Ital Biol. 1999 May;137(2-3):115-26.
Neurological damage may follow even a technically accurate spinal surgery. The intraoperative monitoring of neurological functions put at risk by the operation is a method utilized to correctly identify the topography of neural structures and to avoid surgical insults. SEPs monitoring is 20 year old, and only recently direct motor tract monitoring has become possible. Transcranial electrical motor cortex stimulation with single pulses or with short trains of stimuli and recording of the evoked responses from the spinal epidural space (D-waves) and from limb muscles is a reliable and safe technique for monitoring corticospinal tract activity even under general anesthesia. The method has a solid theoretical experimental background. Its clinical application has demonstrated high sensitivity and specificity. Intraoperative MEPs monitoring is nowadays considered indispensable during spinal neurosurgery.
即使是技术上精确无误的脊柱手术也可能导致神经损伤。对手术中处于风险的神经功能进行术中监测，是一种用于正确识别神经结构的位置并避免手术损伤的方法。体感诱发电位（SEP）监测已有20年历史，而直到最近直接运动通路监测才成为可能。用单脉冲或短串刺激进行经颅电运动皮层刺激，并记录来自脊髓硬膜外间隙（D波）和肢体肌肉的诱发反应，是一种即使在全身麻醉下也能可靠且安全地监测皮质脊髓束活动的技术。该方法有坚实的理论实验基础。其临床应用已证明具有高灵敏度和特异性。如今，术中运动诱发电位（MEP）监测在脊柱神经外科手术中被认为是必不可少的。
