诱发电位联合肌电图在颈段椎管肿瘤手术中的应用

The value of evoked potential combined with electromyography in surgery for the cervical spinal canal tumor

目的探讨诱发电位联合肌电图在颈段椎管肿瘤手术的应用。方法于2018年1月至2020年3月共45例颈部椎管占位患者在诱发电位联合肌电模块下进行切除,分析该技术在颈段椎管肿瘤手术的临床价值。结果全切除41例(91.1%),部分切除4例(8.9%)。该模块下38例出现预警,其中5例运动诱发电位(MEP)预警,14例体感诱发电位(SEP)预警,12例肌电图(EMG)预警,2例MEP+SEP预警,5例SEP+EMG预警;患者术后症状完全消失15例(33.3%),症状改善27例(60%),无改善2例(4.5%),加重1例(2.2%)。术后随访45例患者,其中2例患者失访,2例患者术后复发,1例加重无好转,其余患者恢复良好。结论诱发电位联合肌电技术对患者的预后有重要指导意义,最大程度地保护了脊髓、神经,增加了颈段椎管肿瘤切除的疗效及安全性。

Objective To explore the value of evoked potential combined with electromyography(EMG)module in the cervical spinal canal tumor surgery.Methods 45 patients affected with cervical spinal canal tumor were operated under evoked potential combined with EMG monitoring module from Jan.2018 to Mar.2020.Analyse the relationship between the evoked potential combined with EMG result and the outcomes.Results 41 cases were totally cut(91.1%)with subtotal resection in 4 cases(8.9%).There are early warnings during the evoked potential combined with EMG technology in 38 cases:5 cases of motor evoked potentials(MEP)warning,14 cases of somatosensory evoked potential(SEP)warning,12 cases of electromyography(EMG)warning,2 cases of MEP and SEP warning,5 cases of SEP and EMG warning;There are complete resolution of symptoms in 15 cases(33.3%),with symptoms improvement in 27 cases(60.0%),no significant improvement in 2 cases(4.5%)and worsening symptoms in 1 case(2.2%).Postoperative follow-up was carried out in 45 patients including 2 patients were lost to follow-up,recurrence in 2 patients and aggravating symptoms in 1 patient and the rest of the patients recovered well.Conclusion Evoked potential joint EMG has important significance for the prognosis with patients in the protection of the spinal cord and nerves,increasing the effect and security of cervical spinal canal tumor surgery.