目的初步探讨神经电生理监测技术在椎管内疾病手术中的临床应用价值。方法回顾性分析30例椎管内疾病病人的临床资料。术前Frankel分级:C级4例,D级16例,E级10例。术中应用皮质体感诱发电位(CSEP)与肌电图(EMG)监测脊髓和神经根功能,分析...目的初步探讨神经电生理监测技术在椎管内疾病手术中的临床应用价值。方法回顾性分析30例椎管内疾病病人的临床资料。术前Frankel分级:C级4例,D级16例,E级10例。术中应用皮质体感诱发电位(CSEP)与肌电图(EMG)监测脊髓和神经根功能,分析手术过程并评价其效果。结果肿瘤全切10例,次全切13例,大部切除2例,部分切除2例;另有脊髓栓系综合征3例,术中完全松解黏连病变。术后10 d Frankel分级:改善6例,无变化22例,加重2例;术后1年Frankel分级:改善14例,无变化15例,加重1例。术前Frankel分级3组病人进行比较,术后10 d和1年的疗效差异均无统计学意义(均P>0.05)。结论在椎管内手术中联合应用CSEP与EMG监测可以更好地保护脊髓和神经根功能。展开更多
While the activation of primary somatosensory(SI) cortex during pain perception is consistently reported in functional imaging studies on normal subjects and chronic pain patients,the specific roles of SI,particularly...While the activation of primary somatosensory(SI) cortex during pain perception is consistently reported in functional imaging studies on normal subjects and chronic pain patients,the specific roles of SI,particularly the subregions within SI,in the processing of sensory aspects of pain are still largely unknown.Using optical imaging of intrinsic signal(OIS) and single unit electrophysiology,we studied cortical activation patterns within SI cortex(among Brodmann areas 3a,3b and 1) and signal amplitude changes to various intensities of non-nociceptive,thermal nociceptive and mechanical nociceptive stimulation of individual distal finerpads in anesthetized squirrel monkeys.We have demonstrated that areas 3a and 1 are preferentially involved in the processing of nociceptive information while areas 3b and 1 are preferentially activated in the processing of non-nociceptive(touch) information.Nociceptive activations of individual fingerpad were organized topographically suggesting that nociceptive topographic map exits in areas 3a and 1.Signal amplitude was enhanced to increasing intensity of mechanical nociceptive stimuli in areas 3a,3b and 1.Within area 1,nociceptive response co-localizes with the non-nociceptive response.Therefore,we hypothesize that nocicepitve information is area-specifically represented within SI cortex,in which nociceptive inputs are preferentially represented in areas 3a and 1 while non-nociceptive inputs are preferentially represented in areas 3b and 1.展开更多
文摘目的初步探讨神经电生理监测技术在椎管内疾病手术中的临床应用价值。方法回顾性分析30例椎管内疾病病人的临床资料。术前Frankel分级:C级4例,D级16例,E级10例。术中应用皮质体感诱发电位(CSEP)与肌电图(EMG)监测脊髓和神经根功能,分析手术过程并评价其效果。结果肿瘤全切10例,次全切13例,大部切除2例,部分切除2例;另有脊髓栓系综合征3例,术中完全松解黏连病变。术后10 d Frankel分级:改善6例,无变化22例,加重2例;术后1年Frankel分级:改善14例,无变化15例,加重1例。术前Frankel分级3组病人进行比较,术后10 d和1年的疗效差异均无统计学意义(均P>0.05)。结论在椎管内手术中联合应用CSEP与EMG监测可以更好地保护脊髓和神经根功能。
文摘While the activation of primary somatosensory(SI) cortex during pain perception is consistently reported in functional imaging studies on normal subjects and chronic pain patients,the specific roles of SI,particularly the subregions within SI,in the processing of sensory aspects of pain are still largely unknown.Using optical imaging of intrinsic signal(OIS) and single unit electrophysiology,we studied cortical activation patterns within SI cortex(among Brodmann areas 3a,3b and 1) and signal amplitude changes to various intensities of non-nociceptive,thermal nociceptive and mechanical nociceptive stimulation of individual distal finerpads in anesthetized squirrel monkeys.We have demonstrated that areas 3a and 1 are preferentially involved in the processing of nociceptive information while areas 3b and 1 are preferentially activated in the processing of non-nociceptive(touch) information.Nociceptive activations of individual fingerpad were organized topographically suggesting that nociceptive topographic map exits in areas 3a and 1.Signal amplitude was enhanced to increasing intensity of mechanical nociceptive stimuli in areas 3a,3b and 1.Within area 1,nociceptive response co-localizes with the non-nociceptive response.Therefore,we hypothesize that nocicepitve information is area-specifically represented within SI cortex,in which nociceptive inputs are preferentially represented in areas 3a and 1 while non-nociceptive inputs are preferentially represented in areas 3b and 1.
