经颅磁刺激运动诱发电位监测脊髓创伤的实验研究

An experimental study of spinal cord injury monitoring by transcranial magnetic stimulation MEP

目的：观察脊髓创伤与运动诱发电位的关系，了解运动诱发电位在脊髓中的传导通路。方法：对３９只猫采用脊髓Ａｌｅｎ损伤模型和部分切断伤模型进行经颅磁刺激运动诱发电位（ＴＭＳ－ＭＥＰ）监测。结果：脊髓轻度打击伤时，ＭＥＰ潜伏期即有明显延长，但恢复良好；中度打击伤时，ＭＥＰ潜伏期延长更明显，且不能完全恢复；重度打击伤时，大部分动物ＭＥＰ不能引出，至２４ｈ不能恢复。ＭＥＰ的改变与后肢功能变化及镜下脊髓病理改变一致。ＴＭＳ－ＭＥＰ对脊髓前索和外侧索的损伤敏感，并可间接反应脊髓柱后索损伤。结论：ＴＭＳ－ＭＥＰ经脊髓前索和外侧索传导，可敏感而准确地反映脊髓损伤后功能改变。

Objective:To observe the relationship of spinal cord injury by means of motor evoked potential (MEP) and conduction pathway of transcranial magnetic stimulation (TMS) MEP in spinal cord.Method:Used TMS MEP to monitor spinal cord function on Allen model of spinal cord injury and partly spinal cord incision.Result:It was showed that the MEPs delayed obviously after spinal cord was mild injuried but recovered completely 24 hours after,MEPs delayed more obviously while spinal cord was moderately injuried and could partly recovered 24 hours after ward; MEPs delayed seriously or disappeared after spinal cord was strongly injuried and could not recovered.The changes of MEPs were consistent with the changes of function of animal lower limb and pathological observations.TMS MEP was sensitive to the injury of front and lateral column of spinal cord.It could indirectly reflect the injury of the posterior column of spinal cord.Conclusion:TMS MEPs was conduction through front and lateral column of spinal cord, and the changes of MEP could reflect sensitively and spinal cord injury accurately.TMS MEP was an effective method to monitor spinal cord injury.