中国实用神经疾病杂志2025，Vol.28Issue(5)：603-607,5.DOI:10.12083/SYSJ.240134
脊髓损伤患者术中诱发电位监测的价值及甲强龙治疗的效果
Value of intraoperative evoked potential monitoring in patients with spinal cord injury and effect of methylprednisolone
摘要
Abstract
Objective To investigate the value of intraoperative evoked potential monitoring in patients with spinal cord injury and the efficacy of methylprednisolone.Methods Intraoperative monitoring data,somatosensory evoked potentials(SEP)and motor evoked potentials(MEP),and free electromyogram of 930 patients with spinal cord compression or injury in the Spine Surgery Department of Yantaishan Hospital from June 2016 to September 2023 were retrospectively analyzed.The warning value of intraoperative MEP,the changes in MEP after application of methylprednisolone,and the matching of postoperative muscle strength were observed.Results Totally 920 patients obtained effective MEP baseline,and 31 patients had a decrease in MEP amplitude of more than 80％.Within 60 minutes of methylprednisolone infusion,20 cases showed MEP signal recovery of 20％,5 cases showed partial recovery of＜20％,and 3 cases showed no recovery.Three patients who did not receive methylprednisolone had no decrease in muscle strength after surgery,which was a false positive.Among the 28 patients who used methylprednisolone,2 had no change in muscle strength after surgery,18 recovered to their pre-operative level within one week,7 did not recover within one week but recovered within 6 months,and 1 did not recover.The sensitivity,specificity,positive predictive value,and negative predictive value of intraoperative SEP and MEP monitoring were 100％,99.67％,89.65％,and 100％,respectively.The difference in MEP amplitude before and after the application of methylprednisolone was significant(P＜0.05).Conclusion Intraoperative MEP monitoring is of significance in risk assessment of spinal surgery.Methylprednisolone has an objective therapeutic effect on nerve injury,and significant decrease in MEP amplitude indicates spinal cord injury.关键词
脊髓损伤/脊髓受压/诱发电位/术中监测/甲强龙/肌力Key words
Spinal cord injury/Spinal cord compression/Evoked potential/Intraoperative monitoring/Methylprednisolone/Muscle strength分类
临床医学引用本文复制引用
王哲,张剑锋,窦曼曼,刘奎民,姜守朵..脊髓损伤患者术中诱发电位监测的价值及甲强龙治疗的效果[J].中国实用神经疾病杂志,2025,28(5):603-607,5.基金项目
烟台市科技创新发展计划非基础研究类项目(编号:2023YD051) （编号:2023YD051）
