首页|期刊导航|中华医学杂志（英文版）|Value of somatosensory evoked potentials in diagnosis, surgical monitoring and prognosis of cervical spondylotic myelopathy
中华医学杂志（英文版）2008，Vol.121Issue(15)：1374-1378,5.
Value of somatosensory evoked potentials in diagnosis, surgical monitoring and prognosis of cervical spondylotic myelopathy
Value of somatosensory evoked potentials in diagnosis, surgical monitoring and prognosis of cervical spondylotic myelopathy
摘要
Abstract
Background The value of somatosensory evoked potentials (SEPs) in the diagnosis and prognosis of cervical spondylotic myelopathy, as well as the usefulness of monitoring intraoperative potentials in terms of safety and predictive factors were investigated.Methods Each of the 76 myelopathic patients underwent surgical intervention. According to the wave configurations of the SEPs, the cases were categorised into four groups: Type Ⅰ, Ⅱ, Ⅲ and Ⅳ. The clinical myelopathy disability was classified and the severity of neurological deficits was scored. Clinical function after surgery was evaluated. Preoperative potentials and intraoperative monitoring were categorized. The correlations between evoked potentials detection, monitoring, myelopathy disability and surgical outcome in the different groups were discussed. Results According to the configurations of the SEPs, there were 27 patients (36%) of Type Ⅰ, 30 patients (39%) of Type Ⅱ, 8 patients (11%) of Type Ⅲ, and 11 patients (14%) of Type Ⅳ. The categorised evoked potentials were shown to be significantly associated with the clinical representation of myelopathy (P 〈0.01) and the recovery rate from identifiable SEPs waves (groups A, B and C) was significantly higher than unidentifiable waves (group D, P〈0.01). A deterioration of SEPs was detected in 23 cases (30%), whereas there was no change in 40 cases (53%) and improvements in 13 cases (17%). A significant difference in recovery rates could be observed in various monitoring groups within the short-term follow-up period, while there were no obvious differences in the long-term follow-up groups. Conclusions SEP technique is a valuable and practical tool for the diagnosis, monitoring and prognosis of myelopathy. Classified evoked potentials are well correlated with cervical spondyiotic myelopathy disability, and unidentifiable SEPs waves in patients are indicative of a relatively poor outcome. In addition, intraoperative monitoring of SEPs plays an important role in protecting neural structures during cervical spine surgery.关键词
somatosensory evoked potentials/intraoperative monitoring/cervical spondylotic myelopathy/surgeryKey words
somatosensory evoked potentials/intraoperative monitoring/cervical spondylotic myelopathy/surgery分类
医药卫生引用本文复制引用
DING Yu,HU Yong,RUAN Di-ke,CHEN Bo..Value of somatosensory evoked potentials in diagnosis, surgical monitoring and prognosis of cervical spondylotic myelopathy[J].中华医学杂志（英文版）,2008,121(15):1374-1378,5.基金项目
This work was partially supported by a grant from the Research Grants Council of the Hong Kong SAR, China (No. CERG HKU 7130/06E). （No. CERG HKU 7130/06E）
