Departmennt of Neurosurgery, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, No. 26 Shengli Street, Jiang An District, Wuhan, Hubei, 430014, China.
BMC Musculoskelet Disord. 2023 Jun 6;24(1):462. doi: 10.1186/s12891-023-06518-3.
To investigate the effect and value of electrophysiology in the 'triple operation' (selective excision of spastic muscles in the neck, selective resection of the posterior branch of the cervical nerve and accessory neurotomy) of spastic torticollis.
Preoperative electromyography (EMG) examination was performed on 96 patients with spastic torticollis treated in our hospital from January 2015 to December 2019. The results were used to assess the responsible muscles' primary or secondary position and the function of antagonistic muscles and to formulate a personalised surgical plan. A Cascade PRO 16-channel electrophysiological diagnostic system (produced by Cadwell, USA) was used to record the evoked EMG. Target muscles were denervated under intraoperative electrophysiological monitoring and re-examined by EMG six months later to evaluate the efficacy.
The satisfactory rate of target muscle denervation was 95%, and the overall good rate was 79.1%.
Electrophysiological examination and intraoperative application may have a positive value in the selection of the operative method, improving the rate of denervation and evaluating the prognosis of the 'triple operation'.
探讨在痉挛性斜颈“三联手术”（选择性颈肌痉挛切除术、颈神经后支选择性切断术和副神经减压术）中电生理学的作用和价值。
回顾性分析 2015 年 1 月至 2019 年 12 月我院收治的 96 例痉挛性斜颈患者的临床资料，术前均行肌电图（EMG）检查，评估责任肌的主、次要作用位及拮抗肌功能，制定个性化手术方案。采用美国 Cadwell 公司生产的 Cascade PRO 16 通道电生理诊断系统记录诱发电位 EMG。术中在电生理监测下行目标肌肉去神经支配，术后 6 个月再次行 EMG 检查评估疗效。
目标肌肉去神经支配的满意率为 95%，总优良率为 79.1%。
电生理学检查及术中应用对手术方式的选择、提高去神经支配率、评估“三联手术”预后有积极价值。
