Li Kai, Yang Jianwei, Wang Huaibo, Chang Xuejing, Liu Guanjun, Xue Ruiyang, Guo Weitao, Hu Yong
Department of Spine Surgery, The Second Hospital Affiliated to Guangdong Medical University, Zhanjiang, Guangdong, China.
Department of Orthopedics and Traumatology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Front Neurosci. 2024 Sep 9;18:1411016. doi: 10.3389/fnins.2024.1411016. eCollection 2024.
Spinal cord ischemic-reperfusion injury (SCIRI) could occurs during surgical procedures without detection, presenting a complex course and an unfavorable prognosis. This may lead to postoperative sensory or motor dysfunction in areas innervated by the spinal cord, and in some cases, permanent paralysis. Timely detection of SCIRI and immediate waring can help surgeons implement remedial intervention to prevent irreversible spinal cord injury. Therefore, it is crucial to develop a precise and effective method for early detection of SCIRI. This study utilized rat models to simulate intraoperative SCIRI and employed somatosensory evoked potentials (SEP) for continuous monitoring during surgery. In this study, SEP signal changes were examined in six groups with varying severities of SCIRI and one normal control group. SEP signal changes were examined during operations in different groups and correlated with postoperative behavioral and histopathological data. The result demonstrated specific changes in SEP signals during SCIRI, termed as time-varying characteristics, which are associated with the duration of ischemia and subsequent reperfusion. Time-varying characteristics in SEP could potentially serve as a new biomarker for the intraoperative detection of SCIRI. This finding is significant for clinical surgeons to identify and guide early intervention of SCIRI timely. Additionally, this measurement is easily translatable to clinical application.
脊髓缺血再灌注损伤(SCIRI)可能在手术过程中未被察觉地发生,呈现出复杂的病程和不良预后。这可能导致脊髓所支配区域术后感觉或运动功能障碍,在某些情况下还会导致永久性瘫痪。及时检测SCIRI并立即发出警报有助于外科医生实施补救干预,以防止不可逆的脊髓损伤。因此,开发一种精确有效的SCIRI早期检测方法至关重要。本研究利用大鼠模型模拟术中SCIRI,并在手术期间采用体感诱发电位(SEP)进行连续监测。在本研究中,在六个不同严重程度的SCIRI组和一个正常对照组中检查了SEP信号变化。在不同组的手术过程中检查SEP信号变化,并将其与术后行为和组织病理学数据相关联。结果表明,SCIRI期间SEP信号存在特定变化,称为时变特征,这与缺血持续时间和随后的再灌注有关。SEP中的时变特征有可能作为术中检测SCIRI的一种新的生物标志物。这一发现对于临床外科医生及时识别和指导SCIRI的早期干预具有重要意义。此外,这种测量方法很容易转化为临床应用。