神经电生理监测技术在胸椎骨折微创椎弓根螺钉置入中的应用

Application of electrophysiological monitoring in minimally invasive pedicle screw placement for thoracic fractures

目的:分析观察神经电生理监测技术(IONM)在胸椎骨折微创椎弓根螺钉置入中的应用价值。方法:收治胸椎骨折患者46例,微创椎弓根螺钉置入,应用神经电生理监测技术。结果:患者46例,共置入322枚螺钉,置入中,SEP与MEP无明显波动191枚(59.32%),SEP与MEP监测变化89枚(27.63%),但未达报警标准,SEP与MEP监测变化且达到报警标准42枚(13.05%)。与术前相比,术后1周,患者SEP监测结果明显改善,差异有统计学意义(P<0.05)。结论:胸椎骨折微创椎弓根螺钉置入中,应用神经电生理监测技术,尽早发现可能的神经系统损伤,并停止现行操作,尽量减少对神经系统造成的损伤,提高手术安全性,改善预后。

Objective:To analyze the application value of neuroelectrophysiological monitoring(IONM)in minimally invasive pedicle screw placement for thoracic fracture.Methods:46 patients with thoracic vertebral fracture were treated with minimally invasive pedicle screw placement and neuroelectrophysiological monitoring techniques.Results:A total of 322 screws were implanted in 46 patients,there was no significant fluctuation in SEP and MEP in 191 cases(59.32%),SEP and MEP monitoring changes in 89 screws(27.63%),but did not reach the alarm standard,SEP and MEP monitor changes and reach the alarm standard in 42 screws(13.05%),compared with preoperative,1 week after operation,the SEP monitoring results were significantly improved, the difference was statistically significant(P<0.05).Conclusion:In the minimally invasive pedicle screw placement of thoracic vertebral fracture,neuroelectrophysiological monitoring technology is used to detect possible nervous system injury as soon as possible,and stop the current operation,minimize the damage to nervous system,improve the safety of operation and improve the prognosis.