Tian-Yu Bai, Hai Meng, Ji-Sheng Lin, Zi-Han Fan, Qi Fei
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引用次数: 0
Abstract
Objective: To analyze the value of intraoperative neurophysiological monitoring (IONM) in unilateral biportal endoscopic (UBE) lumbar spine surgery.
Methods: A retrospective analysis was performed on 127 patients who underwent UBE lumbar spine surgery at Xicheng Branch of Beijing Friendship Hospital from January 2024 to September 2024. Patients were divided into two groups: the observation group (IONM, 64 cases) and the control group (no IONM, 63 cases). Changes of monitoring indicators included somatosensory evoked potentials (SEP), motor evoked potentials (MEP), and free electromyography (freeEMG) were recorded. Age, sex, body mass index, surgery length, surgical levels, surgery time, intraoperative fluid volume, post anesthesia care unit time, time to first ambulation, length of hospital stay, leg visual analog scale (VAS), preoperative and postoperative fall scores, activities of daily living, and postoperative complication of two groups were collected and compared.
Results: In the observation group, 40 cases (62.5%) showed freeEMG stimulation. 10 cases (15.6%) had a significant decrease in MEP amplitudes, with 9 cases showing a decline in MEP amplitudes immediately following freeEMG stimulation. No significant changes in SEP. The postoperative 24-hour leg VAS in the observation group was 1.8 ± 0.4, which was significantly lower than the 2.1 ± 0.2 in the control group (p < 0.001). No significant differences were found between the two groups in terms of surgical time and other data (p > 0.05).
Conclusion: IONM provides timely information of neurological function in UBE lumbar spine surgery, reduces the invasiveness of intraoperative procedures, and reduce early postoperative leg pain.
期刊介绍：
Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues.
Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications.
JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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