Leung Victoria, Pugh Jeffery, Norton Jonathan A
Division of Neurosurgery, Department of Surgery, and.
J Neurosurg Pediatr. 2015 Apr;15(4):434-7. doi: 10.3171/2014.10.PEDS1434. Epub 2015 Jan 30.
The diagnosis of tethered cord syndrome (TCS) remains difficult, and the decision to operate is even more complex. The objective of this study was to examine how detailed examination of neurophysiological test results can affect the diagnosis for patients undergoing a surgical cord release.
Patients undergoing tethered spinal cord releases were matched by age and sex with control patients undergoing scoliosis correction in the absence of spinal cord pathology. The latency and width of the P37 peak of the posterior tibial nerve somatosensory evoked potential (SSEP) and the motor evoked potential (MEP) latencies were examined. Immediate changes as a result of the surgical procedure were reported.
The width of the P37 response differed significantly between TCS and control patients and changed significantly during the surgical procedure. Nonsignificant trends were seen in SSEP and MEP latencies.
The width of the P37 response may be a useful marker for TCS and may play a role in presurgical decision making.
脊髓拴系综合征（TCS）的诊断仍然困难，而手术决策则更为复杂。本研究的目的是探讨对神经生理测试结果进行详细检查如何影响接受脊髓松解手术患者的诊断。
将接受脊髓拴系松解术的患者与在无脊髓病变情况下接受脊柱侧弯矫正的对照患者按年龄和性别进行匹配。检查胫后神经体感诱发电位（SSEP）P37波峰的潜伏期和波宽以及运动诱发电位（MEP）潜伏期。报告手术过程中产生的即时变化。
TCS患者与对照患者之间P37反应的波宽存在显著差异，且在手术过程中发生了显著变化。SSEP和MEP潜伏期出现不显著的趋势。
P37反应的波宽可能是TCS的一个有用标志物，并且可能在术前决策中发挥作用。
