Shinomiya K I, Furuya K, Kamikozuru M, Nakai O, Kaneda A, Yamaura I, Sato H, Sato R
Nihon Seikeigeka Gakkai Zasshi. 1982 Nov;56(11):1551-60.
Monitoring of the spinal cord function by evoked spinal cord potentials (ESP) has come to be used widely with the establishment of a safe technique using an epidural electrode and the great improvement in medical electronic devices. According to other investigations ESP has been recorded through an electrode placed in the posterior epidural space, it is well known that residual ESP can be actually recorded after transection of the posterior half of the spinal cord and that ESP shows no change after a small transection of the anterior column. If ESP originating from the anterior half of the spinal cord is recorded, it is very useful for monitoring during anterior decompression surgery for myelopathy such as ossification of the posterior longitudinal ligament and cervical spondylosis. The purpose of this report is to analyse ESP originating from the anterior half of the spinal cord experimentally and further investigate the ESP monitoring clinically. Sixty cats were used in this study. ESP recording principally consisted of stimulation to the spinal cord at the level of thoracic or lumbar region and recording of ESP with a monopolar electrode placed in the cervical epidural space. Changes in the ESP after transection and compression of the spinal cord were analysed. Anterior vertebrectomy and laminectomy at C2 and C6 were performed for the purpose of placing an electrode correctly and facilitating transection or compression of the spinal cord. Recording electrodes were placed on both the anterior and posterior surfaces of the dura mater at C2. As the result of this study, it is apparent that there exists the ESP originating from the anterior half of the spinal cord. Such ESPs are more accurately recorded through an anterior placed electrode rather than through that placed posteriorly.
随着使用硬膜外电极的安全技术的建立以及医疗电子设备的极大改进,通过脊髓诱发电位(ESP)监测脊髓功能已得到广泛应用。根据其他研究,ESP是通过放置在后硬膜外间隙的电极记录的,众所周知,在脊髓后半部横断后仍可实际记录到残余ESP,并且在前柱小范围横断后ESP无变化。如果记录到源自脊髓前半部的ESP,对于诸如后纵韧带骨化和颈椎病等脊髓病的前路减压手术中的监测非常有用。本报告的目的是通过实验分析源自脊髓前半部的ESP,并进一步临床研究ESP监测。本研究使用了60只猫。ESP记录主要包括在胸段或腰段水平刺激脊髓,并使用置于颈段硬膜外间隙的单极电极记录ESP。分析了脊髓横断和受压后ESP的变化。为了正确放置电极并便于脊髓横断或受压,在C2和C6进行了前路椎体切除术和椎板切除术。记录电极置于C2硬脑膜的前后表面。本研究结果表明,显然存在源自脊髓前半部的ESP。通过置于前方的电极比置于后方的电极能更准确地记录此类ESP。