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周围神经手术中的术中神经生理监测:一个中心的技术描述与经验

Intraoperative neurophysiological monitoring in peripheral nerve surgery: Technical description and experience in a centre.

作者信息

Herrera-Pérez M, Oller-Boix A, Pérez-Lorensu P J, de Bergua-Domingo J, Gonzalez-Casamayor S, Márquez-Marfil F, Díaz-Flores L, Pais-Brito J L

机构信息

Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Canarias, La Laguna, Tenerife, España; Facultad de Medicina, Universidad de La Laguna, La Laguna, Tenerife, España.

Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Canarias, La Laguna, Tenerife, España.

出版信息

Rev Esp Cir Ortop Traumatol. 2015 Jul-Aug;59(4):266-74. doi: 10.1016/j.recot.2014.11.004. Epub 2015 Jan 5.

Abstract

INTRODUCTION

Intraoperative neurophysiological monitoring has experienced a spectacular development in the past 20 years, particularly in the fields of neurosurgery and spine surgery. it has become a useful, almost indispensable, tool in preventing nerve damage during surgery. The aim of this article is to describe the intraoperative technique and analyze its results in the field of peripheral nerve surgery.

OBJECTIVE

To describe the usefulness of a technique in peripheral nerve surgery, the technique used and the experience in a centre.

PATIENTS AND METHODS

A retrospective study was conducted on 30 cases of peripheral nerve surgery performed in this centre from 2009 to 2013, using the intraoperative monitoring technique.

RESULTS

Of the total of 13 peripheral nerve tumors recorded, there were 11 excellent results and 2 good results, one temporary hypoesthesia and one with almost complete sensory, except for motor, recovery. Traumatic injury was recorded in 17 cases, of which 6 required performing a graft, and the remaining 11 cases only neurolysis was performed, with complete motor and sensory recovery.

CONCLUSIONS

Intraoperative neurophysiological monitoring is a useful tool in the secondary surgery of peripheral nerve injury and the intraneural tumor pathology.

摘要

引言

术中神经生理监测在过去20年中取得了显著发展,尤其是在神经外科和脊柱外科领域。它已成为手术中预防神经损伤的一种有用且几乎不可或缺的工具。本文旨在描述术中技术并分析其在周围神经外科领域的结果。

目的

描述一种技术在周围神经外科中的实用性、所使用的技术以及在一个中心的经验。

患者与方法

对该中心2009年至2013年采用术中监测技术进行的30例周围神经外科手术进行回顾性研究。

结果

在记录的13例周围神经肿瘤中,11例结果优秀,2例结果良好,1例出现暂时感觉减退,1例除运动功能外几乎完全感觉恢复。记录到17例创伤性损伤,其中6例需要进行移植,其余11例仅进行了神经松解,运动和感觉功能完全恢复。

结论

术中神经生理监测是周围神经损伤二次手术和神经内肿瘤病理手术中的一种有用工具。

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