Pusat Serhat, Kural Cahit, Solmaz Ilker, Temiz Caglar, Kacar Yunus, Tehli Ozkan, Kutlay Murat, Daneyemez Mehmet, Izci Yusuf
Gulhane Military Medical Academy, Department of Neurosurgery, Ankara, Turkey.
Turk Neurosurg. 2017;27(5):797-803. doi: 10.5137/1019-5149.JTN.17043-16.0.
Electrophysiological evaluation of the outcomes of spinal procedures is important for neurosurgeons. Somatosensorial evoked potentials (SSEPs) are used for electrophysiological evaluation of tethered cord syndrome (TCS) and spinal intradural tumors (SIT). The aim of this study was to document the electrophysiological outcomes of surgery for TCS and SIT and to compare the results based on the preoperative diagnosis.
The data of 30 patients, who were operated for TCS and SIT between 2011 and 2013, were reviewed retrospectively. Surgical release of the spinal cord was performed for TCS and tumor removal was performed for SIT. Median and tibial nerve SSEPs at the left and right sides were measured at preoperative, early and late postoperative periods and compared statistically based on the diagnosis and the time of electrophysiological assessment.
The diagnosis was TCS in 12 (40%) patients and SIT in 18 (60%) patients. There was a significant difference between preoperative, and early and late postoperative SSEPs values. Tibial nerve latencies were prolonged in the early postoperative, but shortened in the late postoperative period. In contrast, median nerve latencies were shortened in the early postoperative, but prolonged in the late postoperative period. There was no significant difference between the TCS and SIT groups based on the surgical intervention.
Tibial nerve latency may be prolonged in the early postoperative period of TCS and SIT patients. However, electrophysiological changes were not predictive for these patients. Further studies with more patients are needed for other spinal lesions.
对神经外科医生而言,脊柱手术结果的电生理评估至关重要。体感诱发电位(SSEPs)用于脊髓拴系综合征(TCS)和脊髓硬膜内肿瘤(SIT)的电生理评估。本研究的目的是记录TCS和SIT手术的电生理结果,并根据术前诊断比较结果。
回顾性分析2011年至2013年间接受TCS和SIT手术的30例患者的数据。对TCS患者进行脊髓松解术,对SIT患者进行肿瘤切除术。在术前、术后早期和晚期测量左右两侧的正中神经和胫神经SSEPs,并根据诊断和电生理评估时间进行统计学比较。
12例(40%)患者诊断为TCS,18例(60%)患者诊断为SIT。术前、术后早期和晚期的SSEPs值存在显著差异。胫神经潜伏期在术后早期延长,但在术后晚期缩短。相比之下,正中神经潜伏期在术后早期缩短,但在术后晚期延长。基于手术干预,TCS组和SIT组之间无显著差异。
TCS和SIT患者术后早期胫神经潜伏期可能延长。然而,电生理变化对这些患者并无预测作用。对于其他脊柱病变,需要对更多患者进行进一步研究。