Wang Shujie, Zhuang Qianyu, Zhang Jianguo, Tian Ye, Zhao Hong, Wang Yipeng, Zhao Yu, Li Shugang, Weng Xisheng, Qiu Guixing, Shen Jianxiong
Department of Orthopedics, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, People's Republic of China.
Eur Spine J. 2016 Oct;25(10):3194-3200. doi: 10.1007/s00586-015-4205-6. Epub 2015 Sep 1.
To explain the intra-operative transcranial motor evoked potential (MEP) monitoring can work well in patients with neural axis abnormality (NAA).
One hundred eighteen consecutive NAA and 334 adolescent idiopathic scoliosis (AIS) patients who underwent spinal deformity surgery between June 2010 and April 2013 in our spine center were included. The MEP data including the success rate of obtaining a baseline, amplitude, sensitivity and specificity were analyzed.
High-efficiency MEPs baseline could be obtained in 117/118 NAA (74 congenital scoliosis, 32 neuromuscular scoliosis, 8 adult scoliosis, 3 congenital kyphoscoliosis and 1 neurofibromatosis scoliosis) and 334 AIS cases. They had an approximate level in success rate of MEPs baseline (99.2 vs. 99.7 %) and MEPs amplitude (317 μV, n = 118; vs. 312 μV, n = 334). The sensitivity and specificity for MEP were 100 and 98.2 % in patients with NAA. And the MEPs amplitude value fitted positive-skewed distribution in both of NAA and AIS.
Intraoperative MEP monitoring can be used accurately and satisfactorily in NAA patients and show no difference compared with AIS.
解释术中经颅运动诱发电位(MEP)监测在神经轴异常(NAA)患者中能良好发挥作用的原因。
纳入2010年6月至2013年4月在我院脊柱中心接受脊柱畸形手术的118例连续性NAA患者和334例青少年特发性脊柱侧凸(AIS)患者。分析MEP数据,包括获得基线的成功率、波幅、敏感性和特异性。
118例NAA患者(74例先天性脊柱侧凸、32例神经肌肉型脊柱侧凸、8例成人脊柱侧凸、3例先天性脊柱后凸侧凸和1例神经纤维瘤病性脊柱侧凸)和334例AIS患者均能高效获得MEP基线。他们在MEP基线成功率(99.2%对99.7%)和MEP波幅(317μV,n = 118;对312μV,n = 334)方面水平相近。NAA患者中MEP的敏感性和特异性分别为100%和98.2%。NAA和AIS患者的MEP波幅值均呈正偏态分布。
术中MEP监测在NAA患者中可准确、满意地应用,与AIS患者相比无差异。