Shigematsu Hideki, Miyabayashi Tomoshige, Kawasaki Sachiko, Suga Yuma, Tanaka Yasuhito
Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, 6348522, Japan.
Division of Central Clinical Laboratory, Nara Medical University, Nara, Japan.
Eur Spine J. 2022 Dec;31(12):3731-3735. doi: 10.1007/s00586-022-07172-4. Epub 2022 Mar 26.
Transcranial electrical stimulation motor-evoked potentials (TES-MEPs) are an intraoperative neurophysiologic monitoring method that reduces adverse outcomes in various spine surgeries. Although spine surgeons rarely use TES-MEPs for simple lumbar decompression surgery, we herein firstly report the efficacy of TES-MEPs for lumbar spinal canal stenosis with asymptomatic coexisting cervical canal stenosis.
We report the case of a 71-year-old man who underwent lumbar decompression surgery for lumbar spinal canal stenosis. He had asymptomatic cervical spinal canal stenosis before surgery.
TES-MEPs showed apparent derivation failure of wave amplitudes from the upper and lower limb muscles immediately after posture change from supine to prone for operative preparation. The cervical alignment was corrected. Subsequently, the TES-MEP wave amplitudes became derivable immediately.
While TES-MEPs can be used to prevent neurological deficits in lumbar spine surgery, it can also be used to indirectly monitor other spinal lesions. Based on our experience, we recommend using TES-MEPs even in lumbar spine surgery.
经颅电刺激运动诱发电位（TES-MEPs）是一种术中神经生理监测方法，可减少各种脊柱手术中的不良后果。尽管脊柱外科医生很少在单纯腰椎减压手术中使用TES-MEPs，但我们在此首次报告TES-MEPs对合并无症状性颈椎管狭窄的腰椎管狭窄症的疗效。
我们报告了一例71岁男性因腰椎管狭窄接受腰椎减压手术的病例。他术前存在无症状性颈椎管狭窄。
在为手术准备从仰卧位变为俯卧位后，TES-MEPs显示上肢和下肢肌肉的波幅明显出现引出失败。颈椎对线得到纠正。随后，TES-MEP波幅立即变得可引出。
虽然TES-MEPs可用于预防腰椎手术中的神经功能缺损，但它也可用于间接监测其他脊柱病变。根据我们的经验，我们建议即使在腰椎手术中也使用TES-MEPs。
