ABSTRACT
Objective To study intraoperative neural electrophysiological monitoring applied in lumbosacral spinal cord tumor resection.Methods We retrospectively reviewed the clinical data of 212 patients undergoing lumbosacral spinal cord tumor resection with or without intraoperative neural electrophysiological monitoring in our hospital.The patients were divided into two groups:124 patients in the monitored group received intraoperative neural electrophysiological monitoring while 88 ones in the control group did not.The monitoring was performed by recording the cortical somatosensory evoked potential (CSEP),dermatomal somatosensory evoked potential (DSEP) and electromyography (EMG).The patients were followed up for 3-6 months and their postoperative outcome was analyzed.Results There were significant differences in the outcome (P <0.05),but no difference was found in the incidence of complications between the monitored group and the control group.The sensitivity of CSEP +DSEP+EMG was 100%,and the specificity was 55.9% in the former group.Conclusion Combined monitoring with CSEP,DSEP and EMG during lumbosacral spinal cord tumor resection is valuable in protecting the spinal nerve roots and ensuring better operation safety.
ABSTRACT
Objective To expore the application of intraoperative neural electrophysiological monitoring in microvascular decompression (MVD)of idiopathic facial spasm (HFS), and to clarify the effect of MVD in increasing the operative efficacy of MVD and decreasing the postoperative complications.Methods From December 2010 to December 2014,163 patients with HFS received MVD were selected;from December 2010 to December 2010,73 patients with facial spasm without electrophysiological monitoring in the operation were used as control group;from January 2013 to December 2014,90 patients with facial spasm with BAEP/LSR/FN MEP monitoring in the operation were used as monitoring group.The postoperative efficiency of MVD and the occurrence of hearing loss,dizziness, facial paralysis and other complications after operation were compared between two groups. Results The immediate efficiency in monitoring group was 52.55% (47 cases), minor facial paralysis 1.11%(1 case),hearing loss and dizziness 5.56% (5 cases).The postoperative follow-up time was 6 to 12 months,an average of 9.6 months; the facial paralysis, hearing loss, and dizziness were significantly improved and the operation efficiency was 65.56% (59 cases).The Immediate efficiency in control group was 30.14% (22 cases), minor facial paralysis 13.69% (10 cases),hearing loss and dizziness 23.29% (17 cases);the postoperative follow-up time was 6 to 12 months,an average of 9.6 months;the facial paralysis,hearing loss,and dizziness were significantly improved, and the operation efficiency was 64.38% (47 cases ). The immediate surgery had statistically significant difference between two groups (P 0.05).The incidence of facial paralysis, hearing loss and the incidence of complications such as dizziness had statistically significant differences between two groups (P <0.05),and monitoring group was better than control group.Conclusion LSR monitoring can improve the short-term curative efficiency of facial nerve MVD,but the significance for the long-term curative efficiency is not obvious; BAEP, LSR and FN MEP monitoring have great significance in identification of responsibility vessel,judgement of decompression effect and surface and auditory nerves protection.