诱发肌电图刺激电流阈值与螺钉位置关系模型建立及影响因素分析

Clinical application of the model between galvanic threshold of intraoperative evoked electromyography monitoring and position of the pedicle screws

目的研究诱发肌电图刺激电流阈值与椎弓根螺钉距离椎弓根内侧壁量化关系方程模型,探讨该方程模型的影响因素。方法对腰椎后路椎弓根固定的58例患者256个螺钉建立刺激电流阈值推算椎弓根螺钉与椎体后壁内侧之间距离的回归方程,同时判断性别、手术材料、麻醉方式及骨质疏松对回归方程的影响。结果刺激电流阈值推算椎弓根螺钉与椎体后壁内侧之间距离的回归方程为y=0.444x-2.28,在距离差异无统计学意义的前提下,不同性别、麻醉方式、螺钉类型组间阈值差异无统计学意义(P>0.05),骨质疏松组与非骨质疏松组间阈值差异有统计学意义(P<0.05)。结论通过建立诱发肌电图刺激电流阈值与螺钉位置关系模型,可以减少医源性神经根损伤;患者如合并骨质疏松可影响阈值判断。

Objective To study the evoked electromyography stimulation current threshold distance with pedicle me-dial wall of the pedicle screw quantitative relationship equation model to investigate the influencing factors of the equa-tion model.Methods The regression equation between the distance threshold stimulation current calculation and the medial wall of pedicle screws was established after 58 cases of posterior pedicle fixation with 256 screws,and also sex,material,operation anesthesia and osteoporosis effect on the regression equation were determined.Results stimulation current threshold with vertebral pedicle screw projected distance between the inner wall regression equation y=0.444x-2.28,On the premise of no significant difference under different distance,no significant difference in gender,anesthesia,screw type group threshold （P〉0.05）,there was significant difference between the threshold of osteoporosis group and non osteoporosis group （P〈0.05）.Conclusions Through the establishment of evoked elec-tromyography stimulation current threshold and the screw position model,the iatrogenic injury of nerve root can be re-duced,patients with osteoporosis can affect the threshold.