体感诱发电位在颈椎病手术监护中的应用

The clinical analysis of somatosensory evoked potential used as an intraoperative monitoring method in cervical spondylot ic myelopathy

目的:分析皮层体感诱发电位(somatosensoryevokedpotential,SEP)在颈椎病术中监护的应用价值及其在判断颈椎病预后中的作用。方法:对75例颈椎病患者术中行SEP监护,分析患者手术前、后的JOA评分及术前、术中、术终及恢复期的SEP变化,了解SEP变化与神经功能恢复之间的关系。结果:14例(18.7%)术中波幅有轻度下降,潜伏期轻度延长,术终又恢复到接近术前水平,51例(68%)术前、术中、术终几乎无变化,9例(12%)术中有明显恢复,以上多数病人功能恢复良好;1例(1.3%)术中有波幅下降和潜伏期延长,术后症状加重。在症状改善明显患者中,术后随访SEP均有潜伏期缩短或波幅明显增高。结论:SEP的变化与患者的神经功能恢复有一定的关系。SEP可以作为颈椎病术中监护及预后判断的指标。

Objective:To analyze the r esult of somatosensory evoked potential(SEP)used as an intraoperative monitoring method in cervical spondylotic myelopathy(CSM),and the role of SEP in motor fun ction prognosis.Method:Seventy-five cases of cervical surgery were being monitor ed by intraoperative SEP.In these cases,the patients' changes of JOA score and S EP in preoperative,intraoperative,postoperative stages were analyzed.The relatio nship between the changes of SEP and neurological function was studied.Result:14 cases(18.7%)had a slight decreased amplitude or lasting of latent period during the operation,but recovered nearly to the former level at the end of the operati on.Fifty-one cases(68%)had no change during the operation.Nine cases(12%)had an obvious recovery in amplitude or latent period.All above had a good recovery of symptom after operation.One cases(1.3%)had a bad result.In the cases which had a good recovery,the amplitude or latent period of SEP improved at follow-up time. Conclusion:SEP can reflect the neurological function,and is a valuable method in monitoring cervical surgery and judging the prognosis.