Albanese S A, Spadaro J A, Lubicky J P, Henderson N A
Department of Orthopedic Surgery, SUNY Health Science Center, Syracuse.
Spine (Phila Pa 1976). 1991 Aug;16(8 Suppl):S371-4.
The somatosensory cortical evoked potentials recorded during posterior spine fusion and instrumentation for 99 consecutive patients with idiopathic scoliosis, 18 years of age or younger, were retrospectively reviewed. The potentials were recorded from scalp electrodes while synchronously stimulating both tibial nerves near the ankles. Signal changes observed during consecutive 30-minute time intervals after deformity correction were analyzed. No changes in neurologic status were observed postoperatively. Latency values tended to remain constant on average. A small, but statistically significant, decrease in the first two interpeak amplitudes was observed during the first 30-minute interval after deformity correction. The first interpeak amplitude recovered, while the second remained statistically significantly decreased. No patient had a decrease of greater than 50% in both of the first two amplitudes, which persisted throughout the 60-minute interval immediately after deformity correction. This study demonstrated a tendency for somatosensory cortical evoked potential interpeak amplitudes to decrease during the first 30 minutes after deformity correction. There was a great deal of individual variation, including amplitude increases in many patients. There was no evidence supporting an association between dramatic, sustained amplitude decreases and uncomplicated deformity correction. The value of thoroughly evaluating somatosensory cortical evoked potential signal trends while making intraoperative decisions is emphasized.
对99例18岁及以下特发性脊柱侧凸患者在后路脊柱融合及内固定手术过程中记录的体感皮层诱发电位进行了回顾性研究。在同步刺激双侧踝关节附近的胫神经时，从头皮电极记录电位。分析了畸形矫正后连续30分钟时间间隔内观察到的信号变化。术后未观察到神经功能状态的变化。潜伏期值平均倾向于保持恒定。在畸形矫正后的第一个30分钟间隔内，观察到前两个峰间波幅有轻微但具有统计学意义的下降。第一个峰间波幅恢复，而第二个峰间波幅仍有统计学意义的下降。没有患者在前两个波幅中均下降超过50%，且在畸形矫正后的60分钟间隔内持续存在。本研究表明，在畸形矫正后的前30分钟内，体感皮层诱发电位峰间波幅有下降趋势。个体差异很大，包括许多患者波幅增加。没有证据支持显著、持续的波幅下降与无并发症的畸形矫正之间存在关联。强调了在术中决策时全面评估体感皮层诱发电位信号趋势的价值。
