中国实用神经疾病杂志2025，Vol.28Issue(4)：403-408,6.DOI:10.12083/SYSJ.240503
脊髓手术患者术中体感诱发电位及肌电图监测对术后脊髓功能状态的预测价值
Predictive value of intraoperative somatosensory evoked potential and electromyography monitoring on postoperative spinal cord function in patients undergoing spinal cord surgery
摘要
Abstract
Objective To investigate the predictive effect of somatosensory evoked potential(SEP)and electromyography(EMG)monitoring on spinal cord function in patients undergoing spinal cord surgery.Methods Fifty-eight patients with spinal cord tumors admitted to Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were selected,all of whom underwent spinal cord tumor resection.Intraoperative SEP and EMG monitoring were used to record the latent period,amplitude,conduction velocity(NCV)of common peroneal nerve and tibial nerve and distal latency period(DL)of SEP.The sensitivity and specificity of positive intraoperative monitoring to predict postoperative spinal cord function were analyzed.Results All the 58 patients completed the operation,the average operation time was(3.27±0.52)h,and the average intraoperative blood loss was(1 253.84±564.92)mL.Intraoperative monitoring was normal in 26 cases,SEP alarm occurred in 32 cases,of which 10 cases had irreversible changes in waveform.EMG alarm occurred in 28 cases,all of which recovered after proper treatment and continued to complete the operation.Patients whose SEP alarm amplitude did not recover after surgery were detected as positive,and postoperative sensation was used as the prognosis standard for spinal cord function,the sensitivity of intraoperative monitoring was 60.00%,the specificity was 86.79%,and the area under ROC curve was 0.734(95%CI:0.469-0.999),P>0.05.The postoperative muscle strength was used as the prognostic standard for spinal cord function,the sensitivity of intraoperative monitoring was 50.00%,the specificity was 86.54%,and the area under ROC curve was 0.683(95%CI:0.428-0.938),P>0.05.Any function of postoperative sensation or muscle strength was used as the prognosis criteria for spinal cord function,the sensitivity of intraoperative monitoring was 55.56%,the specificity was 89.80%,and the area under ROC curve was 0.727(95%CI:0.519-0.934),P<0.05.Conclusion Intraoperative SEP and EMG monitoring can effectively predict postoperative spinal cord function and improve the safety of spinal cord surgery.关键词
脊髓肿瘤/脊髓手术/体感诱发电位/肌电图/神经电生理/脊髓功能Key words
Spinal cord tumors/Spinal cord surgery/Somatosensory evoked potential/Electromyography/Neuroelectrophysiology/Spinal cord function分类
临床医学引用本文复制引用
胡静,李海林,叶明,高觉民,吴颐..脊髓手术患者术中体感诱发电位及肌电图监测对术后脊髓功能状态的预测价值[J].中国实用神经疾病杂志,2025,28(4):403-408,6.基金项目
国家自然科学基金项目(编号:82172022) （编号:82172022）
