Hicks R G, Burke D J, Stephen J P
Department of Clinical Neurophysiology, Prince Henry Hospital, Little Bay, NSW.
Med J Aust. 1991 Jan 21;154(2):82-6. doi: 10.5694/j.1326-5377.1991.tb120988.x.
Cotrel-Dubousset instrumentation has been a major advance in spinal surgery but, at least theoretically, it carries a higher risk of spinal cord damage. This paper describes our experience in monitoring the function of either ascending sensory pathways or both ascending sensory and descending motor pathways in the spinal cord during such procedures. Seventy-nine juvenile and adult patients are presented in whom either somatosensory recording (n = 39) or simultaneous corticospinal and somatosensory monitoring (n = 40) was attempted by means of epidural electrodes during corrective surgery with Cotrel-Dubousset instrumentation. Abnormal evoked responses were seen in two cases but these resolved in both before the operation was completed. No new neurological deficits occurred nor were any pre-existing deficits increased.
Cotrel-Dubousset器械在脊柱外科手术中是一项重大进展，但至少从理论上讲，它导致脊髓损伤的风险更高。本文描述了我们在此类手术过程中监测脊髓中上行感觉通路或上行感觉和下行运动通路功能的经验。本文介绍了79例青少年和成年患者，在使用Cotrel-Dubousset器械进行矫正手术期间，通过硬膜外电极尝试进行体感记录（n = 39）或同时进行皮质脊髓和体感监测（n = 40）。在两例病例中观察到异常诱发反应，但在手术完成前两例均恢复正常。未出现新的神经功能缺损，也没有使任何术前已有的缺损加重。
