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术中神经生理监测在脊柱手术中的应用

The Use of Intraoperative Neurophysiological Monitoring in Spine Surgery.

作者信息

Charalampidis Anastasios, Jiang Fan, Wilson Jamie R F, Badhiwala Jetan H, Brodke Darrel S, Fehlings Michael G

机构信息

Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.

出版信息

Global Spine J. 2020 Jan;10(1 Suppl):104S-114S. doi: 10.1177/2192568219859314. Epub 2020 Jan 6.

Abstract

STUDY DESIGN

Narrative review.

OBJECTIVE

To summarize relevant studies regarding the utilization of intraoperative neurophysiological monitoring (IONM) techniques in spine surgery implemented in recent years.

METHODS

A literature search of the Medline database was performed. Relevant studies from all evidence levels have been included. Titles, abstracts, and reference lists of key articles were included.

RESULTS

Multimodal intraoperative neurophysiological monitoring (MIONM) has the advantage of compensating for the limitations of each individual technique and seems to be effective and accurate for detecting perioperative neurological injury during spine surgery.

CONCLUSION

Although there are no prospective studies validating the efficacy of IONM, there is a growing body of evidence supporting its use during spinal surgery. However, the lack of validated protocols to manage intraoperative alerts highlights a critical knowledge gap. Future investigation should focus on developing treatment methodology, validating practice protocols, and synthesizing clinical guidelines.

摘要

研究设计

叙述性综述。

目的

总结近年来脊柱手术中应用术中神经生理监测(IONM)技术的相关研究。

方法

对Medline数据库进行文献检索。纳入了所有证据水平的相关研究。包括关键文章的标题、摘要和参考文献列表。

结果

多模式术中神经生理监测(MIONM)具有弥补每种单独技术局限性的优势,对于检测脊柱手术围手术期神经损伤似乎有效且准确。

结论

尽管尚无前瞻性研究验证IONM的疗效,但越来越多的证据支持其在脊柱手术中的应用。然而,缺乏用于处理术中警报的有效方案凸显了一个关键的知识空白。未来的研究应侧重于开发治疗方法、验证实践方案并综合临床指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d647/6947672/61ad1bbacced/10.1177_2192568219859314-fig1.jpg

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