Liu Yong-Sheng, Zhao Yu
Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Chin Med Sci J. 2017 Dec 30;32(4):260-264. doi: 10.24920/J1001-9294.2017.041.
Thoracic spinal stenosis (TSS) is a group of clinical syndromes caused by thoracic spinal cord compression, which always results in severe clinical complications. The incidence of TSS is relatively low compared with lumbar spinal stenosis, while the incidence of spinal cord injury during thoracic decompression is relatively high. The reported incidence of neurological deficits after thoracic decompression reached 13.9%. Intraoperative neurophysiological monitoring (IONM) can timely provide information regarding the function status of the spinal cord, and help surgeons with appropriate performance during operation. This article illustrates the theoretical basis of applying IONM in thoracic decompression surgery, and elaborates on the relationship between signal changes in IONM and postoperative neurological function recovery of the spinal cord. It also introduces updated information in multimodality IONM, the factors influencing evoked potentials, and remedial measures to improve the prognosis.
胸段脊髓狭窄症(TSS)是一组由胸段脊髓受压引起的临床综合征,常导致严重的临床并发症。与腰椎管狭窄症相比,TSS的发病率相对较低,而胸段减压术中脊髓损伤的发生率相对较高。据报道,胸段减压术后神经功能缺损的发生率达13.9%。术中神经电生理监测(IONM)可及时提供有关脊髓功能状态的信息,并帮助外科医生在手术中做出恰当操作。本文阐述了在胸段减压手术中应用IONM的理论基础,详述了IONM信号变化与脊髓术后神经功能恢复之间的关系。还介绍了多模态IONM的最新信息、影响诱发电位的因素以及改善预后的补救措施。