Haghighi Siavash S
Clinical Neurodiagnostic Department, Sharp Memorial Hospital, San Diego, California 92123, USA.
J Clin Monit Comput. 2002 Jul;17(5):301-8. doi: 10.1023/a:1021210507928.
Clinical utility of high voltage repetitive transcranial electrical stimulation (TES) was investigated in 46 patients undergoing spine surgery.
During spinal surgery, motor evoked potentials (MEPs) were recorded from upper or lower limb muscles following high voltage repetitive TES of motor cortex under propofol and opioid/N2O anesthesia.
The number of responses evoked by the double pulse stimulation was significantly higher than the single pulse stimulation. A similar finding was obtained when repetitive and single pulse stimulation was compared. Compound muscle action potentials (CMAPs) were recorded from upper and lower limbs in 4 patients with cervical spine myclopathy. The CMAP was absent on the affected side in 1 patient, which improved slightly after decompression. Radiculopathy was clinically present in 6 patients undergoing posterior lumbar decompression and fusion. No improvement of MEP was noted intraoperatively after spinal decompression and instrumentation.
The findings suggest that intraoperative MEP monitoring is feasible method, however, its immediate prognostic value for adequacy of neuronal decompression and improvement requires further studies with larger patient population.
对46例接受脊柱手术的患者研究高压重复经颅电刺激（TES）的临床效用。
在脊柱手术期间，于丙泊酚及阿片类药物/氧化亚氮麻醉下对运动皮层进行高压重复TES后，从上肢或下肢肌肉记录运动诱发电位（MEP）。
双脉冲刺激诱发的反应数量显著高于单脉冲刺激。比较重复刺激和单脉冲刺激时也获得了类似结果。从4例颈椎病患者的上肢和下肢记录到复合肌肉动作电位（CMAP）。1例患者患侧CMAP缺失，减压后略有改善。6例接受后路腰椎减压融合术的患者临床上存在神经根病。脊柱减压和器械植入术后术中未观察到MEP改善。
研究结果表明术中MEP监测是一种可行的方法，然而，其对神经减压充分性和改善情况的即时预后价值需要在更多患者中进行进一步研究。
