SEP术中监测对显微内窥镜下腰椎管内神经减压效果评定的临床应用

Intra-operative somatosensory-evoked potentials monitoring in the evaluation of the effect of micro-endoscopy lumbar nerve root decompression

目的 利用节段性皮神经刺激SEP技术,对显微内窥镜下腰椎管内神经减压效果进行术中监测评定,使受压神经在微创手术下获得有效减压。方法 通过对60例常规直视手术患者及58例显微内窥镜下手术患者进行术前、术中监测和术后远期随访,对术后功能改善优良患者的术中电位变化情况进行回顾性研究,确定有效的术中减压效果评定指标。结果 以患者术前麻醉后SEP指标值为基础,术中监测电位变化,若潜伏期缩短10％-15％或波幅增加40％,提示减压充分,预后良好。术中监测电位与术后功能恢复状态符合率为86％-91％。结论 节段性皮神经刺激SEP术中监护能为显微内窥镜下腰椎管内神经减压效果提供即时、客观的术中评定。

Objective To evaluate the effect of micro- endoscopy lumbar nerve root decompression using intra - operative somatosensory-evoked potentials (SEP) monitoring, ensuring the compressed nerve techniques. Methods SEP data of the pre-intra-and postoperative period were collected in 60 cases undergone routine operations under vision as well as during the long-term follow-up. The changes of SEP data in successful function correlated cases were analyzed retrospectively to define the evaluated criteria of adequate decompression which could be referred to during micro - endoscopy operations. Results The baseline of SEP data of the patient under anesthesia was used as the baseline and the changes of SEP were observed during surgery. The data of intra - operative monitoring shortened for 10%-15% or an increase of the amplitude of 40% indicated adequate decompression and a good outcomes can be expected. Conclusion Intra - operative SEP monitoring is an objective and effective method to evaluate the effect of micro - endoscopy nerve root decompression.