Stephen J P, Sullivan M R, Hicks R G, Burke D J, Woodforth I J, Crawford M R
Department of Orthopedic Surgery, Prince of Wales Hospital, Sydney, Australia.
Spine (Phila Pa 1976). 1996 Nov 1;21(21):2450-7. doi: 10.1097/00007632-199611010-00008.
To record prospectively combined motor- and somatosensory-evoked potentials in children during scoliosis surgery using Cotrel-Dubousset instrumentation, without using special anesthetic or muscle relaxant regimens.
To determine the outcome of scoliosis surgery guided by a new technique of monitoring motor- and somatosensory-evoked potentials simultaneously.
Other techniques used to assess cord function generally are limited by special anesthetic requirements or assess only a limited part of the cord or monitor motor function separately from somatosensory function.
Spinal cord function was monitored using epidural leads to record simultaneously the descending motor volley (by transcranial electrical stimulation) and the ascending somatosensory volley (by tibial nerve stimulation) at two spinal levels.
Combined motor- and sensory-evoked potentials were recorded successfully in 138 of 160 children (81%). Changes in evoked potential waveforms were seen in eight patients (5%), but resolved or lessened in response to appropriate measures. Curve correction was satisfactory, and there were no new postoperative deficits or worsening of preexisting deficits in any patient.
A spinal cord monitoring system is described that is safe, reliable, accurate, and makes it unnecessary to resort to the "wake-up" test.
前瞻性记录使用Cotrel-Dubousset器械进行脊柱侧弯手术的儿童的运动诱发电位和体感诱发电位，不使用特殊的麻醉或肌肉松弛方案。
确定一种同时监测运动诱发电位和体感诱发电位的新技术指导下的脊柱侧弯手术的结果。
用于评估脊髓功能的其他技术通常受到特殊麻醉要求的限制，或者仅评估脊髓的有限部分，或者将运动功能与体感功能分开监测。
使用硬膜外电极监测脊髓功能，在两个脊髓节段同时记录下行运动波群（通过经颅电刺激）和上行体感波群（通过胫神经刺激）。
160名儿童中有138名（81%）成功记录了联合运动诱发电位和感觉诱发电位。8名患者（5%）出现诱发电位波形变化，但经适当措施后得到解决或减轻。曲线矫正效果满意，所有患者术后均无新的神经功能缺损或原有缺损加重。
描述了一种安全、可靠、准确且无需进行“唤醒”试验的脊髓监测系统。
