前路颈椎间盘切除融合术中躯体感觉诱发电位监护的应用

Somatosensory evoked potential monitoring during anterior cervical discectomy and fusion

目的明确术中躯体感觉诱发电位(SSEP)监护在前路颈椎间盘切除融合术(anterior cervical discec-tomy and fusion,ACDF)中对辨别可逆性神经损害的原因是否有用。方法采用回顾2007年3月-10月20例SSEP监护ACDF病人的诊疗记录。最后的神经状况是通过电话联系病人或门诊随访确定。结果假阳性1例(5%),假阴性1例(5%),真阴性2例(10%)。结论尽管术中SSEP信号正常,但是仍能出现神经根损伤。SSEP与肌电图或运动诱发电位同时监护可能是一种理想的监护手段,但是还需要进一步研究。

Objective To examine the experience using somatosensory evoked potential （SSEP） monitoring during anterior cervical discectomy and fusion （ACDF）. Methods The complete medical records of 20 patients who underwent ACDF and who were monitored with SSEP during the procedure from March of 2007 to October of 2007 were retrospectively reviewed. Final neurological status was determined through phone contact with patients or outpatient charts of patients. Results There was one case of false positive （5%）, one case of false negative （5%）, 2 cases of true negatives （10%）. Conclusion Impending neurological injury during ACDF is still possible despite of normal SSEP signals. Recording of SSEP, transcanial electrical motor evoked potentials and electromyograms may be useful as these monitoring modalities provide complementary information.