Li Xiaoyu, Zhang Hongqi, Ren Jian
Xuanwu Hospital of Capital Medical University, Beijing, China.
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China International Neuroscience Institute (China-INI), Beijing, 100053, China.
Open Med (Wars). 2024 Oct 18;19(1):20241008. doi: 10.1515/med-2024-1008. eCollection 2024.
The study aimed to evaluate the sensitivity and specificity of these monitoring parameters in predicting postoperative neurological dysfunction.
In this study, a total of 85 patients with spinal cavernous malformations (SCMs) treated at Xuanwu Hospital, Capital Medical University, from November 2012 to August 2017 were included. During the surgical procedures, all patients underwent monitoring of motor evoked potentials (MEP) and somatosensory evoked potentials (SEP). The criteria for warning included a reduction of ≥80% in MEP amplitude and ≥50% in SEP amplitude.
Among 85 patients, 40 (47.1%) had SCMs located in the thoracic segment, 35 (41.2%) in the cervical segment, 6 (7.1%) in the cervical thoracic segment, and 4 (4.7%) in the lumbar segment. MEP recordings were obtained from 81 patients, and the preoperative McCormick score was 1.53 ± 0.69. The sensitivity of multimodal monitoring combined with the criteria of 80% reduction in MEP amplitude and SEP was 83.9%, with a specificity of 69%, a positive predictive value of 69%, and a negative predictive value of 90.4%.
This study emphasizes the crucial role of electrophysiological monitoring, particularly MEP and SEP, during the surgical resection of SCMs. The findings demonstrate that this approach is effective in predicting and preventing postoperative neurological dysfunction, thereby improving patient outcomes.
本研究旨在评估这些监测参数在预测术后神经功能障碍方面的敏感性和特异性。
本研究纳入了2012年11月至2017年8月在首都医科大学宣武医院接受治疗的85例脊髓海绵状血管畸形（SCM）患者。在手术过程中，所有患者均接受了运动诱发电位（MEP）和体感诱发电位（SEP）监测。预警标准包括MEP波幅降低≥80%和SEP波幅降低≥50%。
85例患者中，40例（47.1%）的SCM位于胸段，35例（41.2%）位于颈段，6例（7.1%）位于颈胸段，4例（4.7%）位于腰段。81例患者获得了MEP记录，术前McCormick评分为1.53±0.69。多模式监测结合MEP波幅降低80%和SEP的标准，敏感性为83.9%，特异性为69%，阳性预测值为69%，阴性预测值为90.4%。
本研究强调了电生理监测，尤其是MEP和SEP，在SCM手术切除过程中的关键作用。研究结果表明，这种方法在预测和预防术后神经功能障碍方面是有效的，从而改善了患者的预后。
