术中神经生理监测在脊柱畸形矫形手术中的应用进展

Application and progress of intraoperative neurophysiologic monitoring in surgical correction for spinal deformity

术中神经生理监测作为一种预测神经功能损伤的方法,越来越多的被用于脊柱矫形手术。本文简述了体感诱发电位、运动诱发电位及多模式术中监测在脊柱畸形矫形手术中的应用进展。目的是以标准的监测方法,在脊柱矫形手术中对脊髓功能进行实时的评估,预警术中神经功能损伤的发生。本文就上述监测方法在脊柱畸形矫形术中的临床应用、术中神经损伤的报警标准、麻醉对监测的影响因素、监测安全性和有效性及监测指标的作用做简要综述。

Intraoperative neurophysiologic monitoring as a technique for prediction neurologic deficit, is increasingly being used in the spinal deformity correction procedures. This review has described the application and development of somatosensory evoked potentials（SEP）, motor evoked potentials（MEP） and multimodal intraoperative monitoring（MIOM） during surgical correction of spinal deformity. The objective is to provide the standard monitoring method which is performed at real time in surgical correction of spinal deformity in order to predictive alarm signal for the intraoperative neurologic deficit.In this paper, the clinical application of the monitoring methods during spinal deformity corrections, warning criteria of intraoperative neurologic deficit, anesthesia and effects of monitoring procedure, safety and efficacy and the role of checklist are reviewed.