Glasby Michael A, Tsirikos Athanasios I, Henderson Lindsay, Horsburgh Gillian, Jordan Brian, Michaelson Ciara, Adams Christopher I, Garrido Enrique
Scottish National Spine Deformity Centre, Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF, UK.
Eur Spine J. 2017 Aug;26(8):2103-2111. doi: 10.1007/s00586-016-4737-4. Epub 2016 Aug 23.
To compare measurements of motor evoked potential latency stimulated either magnetically (mMEP) or electrically (eMEP) and central motor conduction time (CMCT) made pre-operatively in conscious patients using transcranial and intra-operatively using electrical cortical stimulation before and after successful instrumentation for the treatment of adolescent idiopathic scoliosis.
A group initially of 51 patients with adolescent idiopathic scoliosis aged 12-19 years was evaluated pre-operatively in the outpatients' department with transcranial magnetic stimulation. The neurophysiological data were then compared statistically with intra-operative responses elicited by transcranial electrical stimulation both before and after successful surgical intervention. MEPs were measured as the cortically evoked compound action potentials of Abductor hallucis. Minimum F-waves were measured using conventional nerve conduction methods and the lower motor neuron conduction time was calculated and this was subtracted from MEP latency to give CMCT.
Pre-operative testing was well tolerated in our paediatric/adolescent patients. No neurological injury occurred in any patient in this series. There was no significant difference in the values of mMEP and eMEP latencies seen pre-operatively in conscious patients and intra-operatively in patients under anaesthetic. The calculated quantities mCMCT and eCMCT showed the same statistical correlations as the quantities mMEP and eMEP latency.
The congruency of mMEP and eMEP and of mCMCT and eCMCT suggests that these measurements may be used comparatively and semi-quantitatively for the comparison of pre-, intra-, and post-operative spinal cord function in spinal deformity surgery.
比较在青少年特发性脊柱侧凸治疗中，术前清醒患者经颅磁刺激测量的磁刺激运动诱发电位潜伏期（mMEP）和电刺激运动诱发电位潜伏期（eMEP）以及中枢运动传导时间（CMCT），与术中成功器械置入前后经皮层电刺激测量的结果。
最初一组51例年龄在12至19岁的青少年特发性脊柱侧凸患者在门诊接受术前经颅磁刺激评估。然后将神经生理学数据与手术成功干预前后经颅电刺激引起的术中反应进行统计学比较。运动诱发电位测量为拇展肌的皮层诱发复合动作电位。使用传统神经传导方法测量最小F波，并计算下运动神经元传导时间，从运动诱发电位潜伏期减去该时间以得出中枢运动传导时间。
我们的儿科/青少年患者对术前测试耐受性良好。该系列中任何患者均未发生神经损伤。清醒患者术前和麻醉患者术中观察到的磁刺激运动诱发电位和电刺激运动诱发电位潜伏期值无显著差异。计算得出的磁刺激中枢运动传导时间和电刺激中枢运动传导时间与磁刺激运动诱发电位和电刺激运动诱发电位潜伏期显示出相同的统计相关性。
磁刺激运动诱发电位与电刺激运动诱发电位以及磁刺激中枢运动传导时间与电刺激中枢运动传导时间的一致性表明，这些测量可用于比较和半定量评估脊柱畸形手术中脊髓功能的术前、术中和术后情况。
