Evaluation of neurologic function and influencing factors in patients with spinal cord surgery
SHEN Qiang1, ZHU Ling2, BAI Xue2, YU Shaobin2, LIU Fengxin2
1.Hebei Provincial Corps Hospital of Chinese People’s Armed Police Force,Shijiazhuang 050081,China; 2.Department of Electromyography, The third hospital of hebei medical university, Shijiazhuang 050000,China
Abstract：Objective To investigate the various electrophysiological signals of the nervous system before and after operation using EMG, SEP and MEP multimode methods, and to explore the neurofunctional status of patients.Methods One hundred patients were collected as subjects, and the SEP and MEP of patients with bilateral lower limbs were monitored. EMG was resumed 6 months after surgery.Results The SEP amplitude and latent period were stable during the operation. In the process of MEP monitoring, the amplitude of D wave was decreased by less than than 50% in 42 patients, but suddenly decreased by more than 50% in 22 patients. Pearson correlation analysis showed that intraoperative blood loss was associated with changes in SEP and MEP amplitude and latency.The postoperative re-examination found that the NCV and DL of the peroneal nerve and tibial nerve in each group were significantly improved, but the abnormal group improved much less significantly than in the other four groups.Conclusions EMG,SEP and MEP multimode neuroelectrophy-siological detection can remove interference and provide Objective and valuable data for diagnosis and treatment of spinal cord surgery.
Bridwell K H, Lenke L G, Baldus C, et al. Major intraoperative neurologic deficits in pediatric and adult spinal deformity patients:incidence and etiology at one institution[J]. Spine, 1998, 23(3): 324-331.
Azabou E, Manel V, Abelin-Genevois K, et al. Predicting intraoperative feasibility of combined TES-mMEP and cSSEP monitoring during scoliosis surgery based on preoperative neurophysiological assessment[J]. Spine J, 2014, 14(7): 1214-1220.
Bhagat S, Durst A, Grover H, et al. An evaluation of multimodal spinal cord monitoring in scoliosis surgery: a single centre experience of 354 operations[J]. Eur Spine, 2015,7(24):1399-1407.
[7]
Herring J A, Wenger D R. Segmental spinal instrumentation: a preliminary report of 40 consecutive cases [J]. Spine, 1982, 7(3): 285-298.
Francesca C,Gianluca C,Davide D L,et al. Excitability of the motor cortex in patients with migraine changes with the time elapsed from the last attack[J]. J Headache and Pain,2017,18:1-3.
2019, Vol. 30 
