Şenköylü Alpaslan, Zinnuroğlu Murat, Börçek Alp, Aktaş Erdem, Güngör İrfan, Beyazova Mehmet
Gazi University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Ankara, Turkey.
Gazi University, Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Ankara, Turkey.
Acta Orthop Traumatol Turc. 2017 Jan;51(1):49-53. doi: 10.1016/j.aott.2016.12.005. Epub 2016 Dec 20.
The aim of this study was to compare the performance of multimodal intraoperative neurophysiological monitoring (MIONM) in children below and over 6 years of age.
43 children, diagnosed with spinal pathologies were divided into two cohorts according to their age and enrolled in the study. Those under the age of 6 consisted group A, whereas those between the age of 6 and 11 consisted group B. All patients underwent spinal surgical procedures according to their diagnosis. A standard anesthesia protocol was given to both groups. Baseline somatosensory evoked potentials (SSEPs) and transcranial electrical motor evoked potentials (tcMEPs) were recorded and evaluated at specific time points for each patient.
Except for the SSEPs in three cases, tcMEPs and SSEPs were recorded for all patients. There was no false-negative whereas 9 false positive recordings due to physiological conditions that all recovered intraoperatively. In 10 patients, MIOMN recorded more than %50 decrement, in which 8 had the kyphosis component. The tcMEPs fully recovered by the end of the operation except for the patient with post-tuberculosis kyphosis. There was no statistically significant difference in the mean threshold values with regard to transcranial stimulus intensity for the tcMEPs between the two groups.
Compared to school aged children, both SSEPs, tcMEPs recordings are feasible and MIONM is effective for early childhood patients undergoing spinal surgery.
Level III, Diagnostic Study.
本研究旨在比较多模式术中神经生理监测（MIONM）在6岁以下和6岁以上儿童中的表现。
43名被诊断患有脊柱疾病的儿童根据年龄分为两组并纳入研究。6岁以下的儿童组成A组，6至11岁的儿童组成B组。所有患者均根据诊断接受脊柱外科手术。两组均采用标准麻醉方案。在每个患者的特定时间点记录并评估基线体感诱发电位（SSEP）和经颅电运动诱发电位（tcMEP）。
除3例患者的SSEP外，所有患者均记录了tcMEP和SSEP。没有假阴性记录，而有9例假阳性记录是由于生理状况导致的，所有这些在术中均恢复。10例患者中，MIOMN记录到超过50%的下降，其中8例有脊柱后凸成分。除结核后脊柱后凸患者外，tcMEP在手术结束时完全恢复。两组之间tcMEP的经颅刺激强度的平均阈值没有统计学上的显著差异。
与学龄儿童相比，SSEP和tcMEP记录对于接受脊柱手术的幼儿都是可行的，并且MIONM是有效的。
III级，诊断性研究。
