外侧手术中的高级神经监测-经腹肌动作电位的作用

Q4 Medicine

Seminars in Spine Surgery Pub Date : 2025-06-01 DOI:10.1016/j.semss.2025.101178

Michael R. McDermott , Alfred-John Bayaton , Dane Wheeler , Ashish Patel

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引用次数: 0

摘要

侧位腰椎椎体间融合术（LLIF）使股神经处于危险之中，尤其是腰4 - 5段。传统的神经监测模式往往不能实时检测急性节段性损伤。经腹肌动作电位（TMAP）刺激髓圆锥并记录下肢肌束反应，提供抵抗麻醉抑制的运动反馈。在我们的研究中，TMAP检测股神经损伤的灵敏度为100%。结构化的、基于事件的TMAP方案提高了术中意识和特异性。当与t-EMG配对时，TMAP锚定了一种多模式策略，可以实现精确、实时的神经监测，并可能通过捕捉损伤发生的那一刻来重新定义LLIF的安全标准。

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Advanced neuromonitoring in lateral surgery – The role of transabdominal muscle action potential

Lateral lumbar interbody fusion (LLIF) places the femoral nerve at risk, particularly at L4–5. Traditional neuromonitoring modalities often fail to detect acute, segmental injuries in real time. Transabdominal Muscle Action Potential (TMAP) stimulates the conus medullaris and records lower extremity myotomal responses, offering motor feedback resistant to anesthetic suppression. In our series, TMAP showed 100 % sensitivity for detecting femoral nerve injury. A structured, event-based TMAP protocol improved intraoperative awareness and specificity. When paired with t-EMG, TMAP anchors a multimodal strategy that enables precise, real-time neuromonitoring and may redefine safety standards for LLIF by capturing injury at the moment it occurs.

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来源期刊

Seminars in Spine Surgery Medicine-Surgery

CiteScore

0.50

自引率

0.00%

发文量

审稿时长

2 days

期刊介绍： Seminars in Spine Surgery is a continuing source of current, clinical information for practicing surgeons. Under the direction of a specially selected guest editor, each issue addresses a single topic in the management and care of patients. Topics covered in each issue include basic anatomy, pathophysiology, clinical presentation, management options and follow-up of the condition under consideration. The journal also features "Spinescope," a special section providing summaries of articles from other journals that are of relevance to the understanding of ongoing research related to the treatment of spinal disorders.