脊柱侧凸手术中神经生理监测的临床意义:文献综述

S. Tanumihardja, D. Supantini, J. Gunadi, A. Sanjaya, Katherine Marcella
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引用次数: 0

摘要

脊柱侧凸矫正过程中神经纤维的机械损伤可导致严重的神经系统疾病。已有研究表明,脊柱手术时术中神经生理监测可降低运动障碍或截瘫的风险。尽管IONM(术中神经生理监测)技术和应用取得了重大进展,但报道术中神经生理监测对脊柱侧凸手术干预影响的数据仍然非常有限。因此,本综述旨在探讨IONM的应用与脊柱侧凸手术患者神经功能缺损风险之间的相关性。该数据库来源于PubMed(2010年1月至2022年1月),用于识别所有评估脊柱侧凸手术中术中神经生理监测的有效性和影响以及降低术后并发症风险的研究。本系统综述包括5项研究。多模态IONM具有较高的敏感性和特异性,为外科医生评估手术策略以降低永久性神经功能缺损的风险提供了客观的基准。多模态IONM可以被认为是脊柱侧凸手术中IONM的金标准,可以预防神经损伤,并提供更令人满意的手术干预结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CLINICAL SIGNIFICANCE OF INTRAOPERATIVE NEUROPHYSIOLOGICAL MONITORING DURING SCOLIOSIS SURGERY: A LITERATURE REVIEW
Mechanical damage to nerve fibers during scoliosis correction can result in severe neurological disorders. It has been demonstrated that intraoperative neurophysiological monitoring during spinal surgery reduces the risk of motor deficits or paraplegia. Despite significant advances in the technique and application of IONM (intraoperative neurophysiological monitoring), data reporting the impact of implementing intraoperative neurophysiological monitoring on scoliosis surgery intervention remains very limited. Therefore, this review aims to investigate the correlation between the application of IONM and the risk of neurologic deficits in scoliosis patients undergoing surgery. The database sourced from PubMed (Jan 2010 to Jan 2022) was used to identify all studies evaluating the effectiveness and impact of intraoperative neurophysiological monitoring during scoliosis surgery and reducing the risk of postoperative complications. This systematic review included five studies. Multimodal IONM, with its high sensitivity and specificity, provides an objective benchmark that surgeons can implement to review surgical strategies to reduce the risk of permanent neurologic deficits. Multimodal IONM can be considered the gold standard of IONM in scoliosis surgery to prevent neurological damage and provide a more satisfactory result of surgical intervention.
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