Combined Monitoring of CSEP and TES-MEP in Surgery of Spinal Canal Space-occupying Lesion
|School||Taishan Medical College|
|Keywords||Spine Intraspinal placeholder Evoked potentials Movement Guardianship|
Objective To investigate the cortical somatosensory evoked potentials ( cortical somatosensory evoked potential CSEP ) combined with transcranial electric motor evoked potential (transcranial electrical stimulation motor evoked potential, TES-MEP) the value placeholder surgery in the cervical thoracic spinal . Method from July 2009 to January 2011 , 52 patients with cervical thoracic spinal placeholder implementation of cortical somatosensory evoked potential monitoring in surgery of the the double anterior tibial muscle , plantar short flexor , gastrocnemius , the size of the thenar muscles ( cervical tube placeholder ) of transcranial electrical stimulation motor evoked potential monitoring . Surgery CCP 352 muscle line movement evoked potential monitoring . All patients were treated with posterior Road . All patients were treated with intraoperative intravenous anesthesia . The results of 9 cases were the evoked potential positive cases , in addition to three cases of unexplained false-positive , 6 cases of surgical operations directly related to . 4 patients surgery , the CSEP significantly improve , the patients surgery CSEP improvement accompanied by the emergence of the part of the muscle TES-MEP . Potential changes in the patients surgery , three hours after the paralysis of the lower limbs , MRI confirmed as caused by postoperative hematoma . CSEP sensitivity 67% , specificity of 95.6% , Youden index 0.66 . Intraoperative TES-MEP sensitivity 85.7% , specificity 97.5% , Youden index was 0.81 . The joint custody sensitivity 100% specificity 97.6% Youden index was 0.97 . Conclusions height, weight , age , monitoring results do not have any impact . Intraoperative the CSEP United TES-MEP guardianship can greatly improve hand security . TES-MEP changes guidance surgery operation to prevent permanent nerve damage . CSEP joint custody TES-MEP can predict the prognosis of patients to a certain extent . CSEP joint custody TES-MEP guide perioperative diagnosis of spinal further injury .