Intraoperative Neurophysiological Monitoring in Patients With Marfan Syndrome Scoliosis.

IF 2.1 2区 医学 Q2 ORTHOPEDICS
Kaiyi Cao, Wanyou Liu, Junyin Qiu, Yinkun Li, Zezhang Zhu, Yong Qiu, Benlong Shi
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引用次数: 0

Abstract

Objective: This study compared the intraoperative neurophysiological monitoring (IONM) data between patients with Marfan syndrome (MFS) scoliosis undergoing posterior spinal correction surgery and those with idiopathic scoliosis (IS).

Methods: Patients diagnosed with MFS who underwent posterior spinal correction surgery between January 2018 and December 2023 were reviewed. Patients with IS who underwent posterior spinal correction surgery were randomly selected as the control group. Motor-evoked potentials (MEPs) and somatosensory-evoked potentials (SEPs) were measured separately on the convex and concave sides of the main curve. We recorded IONM failure and asymmetrical SEPs waveforms. For each patient, we assessed the apical vertebral translation, Cobb angle of the main curve, curve pattern, deformity angular ratio (DAR), and global kyphosis. Independent-sample t-test and chi-square tests were conducted to compare differences between the IS and MFS groups.

Results: We included 238 girls with IS and 118 patients with MFS scoliosis (45 men and 73 women). The rates of MEPs and SEPs were 95.4% and 93.7% in girls with IS, and 92.4% and 89.8% in patients with MFS scoliosis, respectively. In the MFS group, the average N45 latency, P37 latency, and amplitude of SEPs were 49.5 ± 3.9 ms, 39.9 ± 3.5 ms, and 2.5 ± 1.4 μV on the convex side and 50.1 ± 4.0 ms, 39.9 ± 3.5 ms, and 2.4 ± 1.3 μV on the concave side, respectively. The MEP amplitude was 731.7 ± 734.3 μV on the concave side and 854.3 ± 778.2 μV on the convex side. Patients in the IS group had lower SEP-N45 and SEP-P37 latencies than the patients in the MFS group (p < 0.001). Asymmetrical SEPs were observed in 102 patients in the IS group and 52 patients in the MFS group, respectively (p = 0.879). IONM waveform failure was identified in 21 patients in the IS group and 17 patients in the MFS group, respectively (p = 0.108). IONM failure was more likely in patients with a larger C-DAR, S-DAR, T-DAR, and Cobb angle of the main curve preoperatively (p = 0.017, 0.005, 0.001, and 0.001, respectively).

Conclusions: In patients with MFS scoliosis, the success rates of MEPs and SEPs during posterior spinal fusion were 92.4% and 89.8%. Compared to MFS patients, those with IS demonstrated shorter SEP latencies, with similar MEP and SEP amplitudes. MFS patients with higher DAR values and larger Cobb angles of the main curve preoperatively were at a higher risk of IONM failure.

马凡氏综合征脊柱侧凸患者术中神经生理监测。
目的:比较马凡氏综合征(MFS)脊柱侧凸与特发性脊柱侧凸(IS)患者行后路脊柱矫正手术的术中神经生理监测(IONM)数据。方法:回顾2018年1月至2023年12月期间诊断为MFS并接受后路脊柱矫正手术的患者。随机选择行脊柱后路矫正手术的IS患者作为对照组。在主曲线的凹凸两侧分别测量运动诱发电位(MEPs)和躯体感觉诱发电位(SEPs)。我们记录了离子束失效和不对称的sep波形。对于每位患者,我们评估了椎体顶端平移、主曲线的Cobb角、曲线模式、畸形角比(DAR)和整体后凸。采用独立样本t检验和卡方检验比较IS组和MFS组之间的差异。结果:我们纳入了238名患有IS的女孩和118名患有MFS的脊柱侧凸患者(45名男性和73名女性)。IS女孩MEPs和SEPs的发生率分别为95.4%和93.7%,MFS脊柱侧凸患者MEPs和SEPs的发生率分别为92.4%和89.8%。MFS组的N45潜伏期、P37潜伏期和sep振幅平均分别为凸侧49.5±3.9 ms、39.9±3.5 ms和2.5±1.4 μV,凹侧50.1±4.0 ms、39.9±3.5 ms和2.4±1.3 μV。凹侧MEP振幅为731.7±734.3 μV,凸侧MEP振幅为854.3±778.2 μV。与MFS组相比,IS组患者SEP-N45和SEP-P37潜伏期较低(p)。结论:MFS组脊柱侧凸患者后路融合术中MEPs和sep的成功率分别为92.4%和89.8%。与MFS患者相比,IS患者表现出更短的SEP潜伏期,MEP和SEP振幅相似。术前DAR值较高、主曲线Cobb角较大的MFS患者IONM衰竭的风险较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Orthopaedic Surgery
Orthopaedic Surgery ORTHOPEDICS-
CiteScore
3.40
自引率
14.30%
发文量
374
审稿时长
20 weeks
期刊介绍: Orthopaedic Surgery (OS) is the official journal of the Chinese Orthopaedic Association, focusing on all aspects of orthopaedic technique and surgery. The journal publishes peer-reviewed articles in the following categories: Original Articles, Clinical Articles, Review Articles, Guidelines, Editorials, Commentaries, Surgical Techniques, Case Reports and Meeting Reports.
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